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Appendix 4 Case Studies
Case Study 1: Aberdeenshire Staged Intervention Supporting Teaching ( ASSIST).
This case study was selected as an innovative approach to developing the capacity of classroom teachers, and other school staff, to respond appropriately to low level disruptive behaviour. Two schools were involved in the study: one large comprehensive in a rural market town and one small primary school located in an isolated settlement. This account will begin by describing the approach of the ASSIST scheme, then will consider the two schools separately, as they operated their scheme in quite distinct ways. Finally, the implications of the findings will be discussed.
The ASSIST approach
The ASSIST (Aberdeenshire Staged Intervention Supporting Teaching) scheme was introduced by Aberdeenshire Council to support teachers to develop solution focussed environmental responses to low level disruptive behaviour (level 1) which may not be covered by the school's formal discipline policy. It is based on the Birmingham Framework for Staged Intervention, modified to meet local requirements. The first phase of its roll out took place in 2002, to twenty-three schools, and it is currently being introduced to all schools in the authority. ASSIST is managed by the principal educational psychologist, who employs a development officer (on secondment) to implement the scheme in schools. It can be seen to be driven by the more proactive approach taken by psychological services, in recent years, to promote deeper understanding and better practice in schools, in relation to mental health.
The programme emphasises the relationship between the school environment and the behaviour of pupils, and thereby implicitly addresses the impact of the school environment on mental and emotional well being. The environmental approach carries wider benefits for the well being of all pupils, and is not solely focussed on the disruptive individuals.
ASSIST offers a confidential peer support service for teachers. A volunteer ASSIST co-ordinator is trained in each school, to offer a counselling type approach to colleagues who seek support. Participants are self-selecting. The co-ordinator is usually a classroom teacher, but could hold another unpromoted position in the school ( e.g. school counsellor). The co-ordinator should not be a member of senior management (but sometimes is). A supported self-evaluation approach is taken. Co-ordinators are trained to facilitate reflection by the member of staff seeking support, who is the lead person in suggesting potential solutions and evaluating their effectiveness. It is not the role of the co-ordinator to offer advice.
The ASSIST model encourages the evaluation of the situation without prejudice. Neither the teacher nor the pupil is blamed for the situation. Instead discussions should take a solution-focussed approach, concentrating on the changes in behaviour that the teacher would like to see and the strategies that might effect those changes. The focus is deflected from the individual child, to consideration of the unwelcome behaviour, and how that can best be tackled.
By using an environmental model the teacher is encouraged to devise ways of modifying his or her own approaches to class management and organisation, to reflect on delivery of the curriculum and interactions with the pupils. Positive rather than punitive approaches to discipline are encouraged. Any changes that are introduced are applied to the whole class, they are not aimed at a particular pupil. Consequently the approach can be seen to benefit the whole class rather than certain children.
Teachers, or other staff who approach the co-ordinator are asked to evaluate their own classroom environment against an extensive "environmental check list" which forms the basis for more detailed discussions about potential solutions. The teacher is encouraged to identify the unwelcome behaviour in terms of readily observable phenomena (for example "leaving seat" or "flicking rubber") rather than general terms (such as "off task"). These quantifiable behaviours are base-lined before introducing changes, and success can be measured against alterations in frequency.
Follow up meetings judge whether the intervention has alleviated the situation, whether further strategies are required or whether the behaviour merits referral to levels 2 or beyond (at which point the focus returns to the individual child).
The secondary school setting
The ASSIST co-ordinator in this school was, atypically, the school counsellor, rather than a member of the teaching staff, although she was also a trained teacher with a background in behaviour support. This carried a number of advantages. She was well respected, by staff, as having appropriate credentials to act as ASSIST co-ordinator. She was very comfortable with the counselling style approach of ASSIST. And as she was not restricted to a teaching timetable she could offer time more freely and flexibly than a teacher in her position would have been able.
There was perceived, by interviewees to be a great need for this service, as low level indiscipline was viewed as a significant problem for teachers, which fell outside the more formal mechanisms of the whole school referral system. Repeatedly interviewees referred to the stresses created by consistent low level disruption, and role of ASSIST in helping teachers to cope. For example:
There will always be kids causing "dripping problems" and before ASSIST that was not being dealt with. That is where ASSIST is important because it [low level disruption] can be soul destroying for teachers. (Teacher female)
Linked to the stresses of these unwanted behaviours were feelings of inadequacy, as staff felt that they should be able to cope, that they were failing to meet the required standard of control in their classrooms. This in turn, in some cases could make it more difficult for staff to admit to problems and seek help. The ASSIST scheme offered a support to teachers who found themselves in this position. The ASSIST co-ordinator began her interview in this way:
Interviewer: What do you think the focus of this scheme is, what do you think are the objectives behind it?
Co-ordinator: To support staff, especially new members of staff, probationers or staff who have been landed with difficult classes. And their stress levels are rising very highly and I think it is easy for members of staff to become very isolated feeling there is nobody to turn to. They think it is a sign of weakness, not coping, and I think ASSIST is really useful in filling that gap and reassuring that it is not a weakness.
Consequently, the confidentiality of the service was seen by staff and by the co-ordinator as critical to its success. Whilst not all interviewees felt that they personally were reluctant to admit to difficulties with behaviour management, it was widely acknowledged that many staff did view such problems as a sign of failure which they were not comfortable discussing with colleagues. The links between self esteem and classroom management were abundantly evident in the interview data. For example, this teacher, who had used ASSIST described his reluctance to talk openly about his difficulties in coping.
But it [indiscipline] is not something teachers talk about among themselves-it is almost a taboo subject- you know, "how do you cope with that?" Obviously the classes I have, other teachers have but…..
Interviewer: Why do you think that is the case?
It seems as if the discipline, or the behaviour management aspect is how you are judged as a good teacher. And you almost sense that people have a fear of others talking about you as, you know, "His classes, they all run wild with him". As soon as you admit that, for example, 4B were a nightmare today, it is "Oh look at him, he is not a good teacher". (Teacher male)
Additionally the confidentiality guaranteed by ASSIST was seen by many as a means of addressing issues without compromising their reputation with their superiors. A number of respondents were mindful of the importance of maintaining the appearance of being able to operate independently, and they felt that admitting to problems could affect future career prospects. Although the scheme guaranteed confidentiality, anonymity was impossible, since staff could be seen entering and leaving the room. This could possibly act as a disincentive to some teachers to seek help when they needed to.
The teachers who had used ASSIST could identify a range of benefits of the scheme. It was generally felt that the co-ordinator had been effective in supporting them to re-evaluate their own practice and develop new approaches. One teacher who had been struggling with a "difficult" class described her changed strategy:
So it maybe made me look at myself and the way I speak to pupils, you know. Maybe it made me less confrontational and I kept reminding them that this is the expectation, this is your choice and if you want to behave in this way you will have to think about what is going to happen as a result of that behaviour. (Teacher, female)
There was a strong sense of appreciation of the counselling style approach which was used during the sessions. Having access to a non-judgmental confidante was an extremely valuable resource for these teachers, as many would be having strong feelings of self-doubt as they approached the ASSIST scheme.
She never once said" You are doing this wrong"…so you never feel you are being accused (Teacher female).
Another teacher referred to it as a "non threatening environment" and went on to say:
I like that fact that I can be open and say, "Look I am really not coping with this and I am at my wits end with this particular group of pupils"
For some the function of ASSIST had become seen as a general staff counselling service rather than one which was specifically geared towards issues of low level disruption. A number of staff had sought support with other issues for example, departmental policies and relationships with other teachers. Given her professional background, the ASSIST co-ordinator was able and willing to meet these needs when they arose, and did not feel obliged to draw strict boundaries around her role.
Within the teaching staff there was reported to be a level of indifference, or even active resistance to the ASSIST scheme, and to other innovative behaviour management strategies, similar to some attitudes reported in other case studies. Whilst all those staff who participated in the study were supportive of the scheme, there were repeated references to a small, but notable group of teachers who did not welcome any new approaches, as suggested here:
I would say there is a stigma amongst the teachers, especially those older more cynical teachers who have been through the system without the support and maybe they don't understand why it should be there now because they "coped" (Teacher, female)
These people, were not amongst the volunteer interviewees for our project either as users or non users of the scheme, so we cannot directly represent their views, but none the less, the existence of a significant group of people who were readily identifiable by other staff, highlights one of the barriers to introducing innovative practice into schools.
It was the intention of the Development Officer that individual schools would adapt the ASSIST scheme to suit their circumstances, as indeed has been the case. If we re-visit the original intentions of the scheme we can see that in this school the confidential, self-evaluative approach, supported by non-judgmental counselling, was in place, and deemed to be effective by users. Teachers were less aware of solution focused thinking, and similarly did not readily take the focus of their thinking off the child. Consequently the scheme appeared to be interpreted by its users in ways which were helpful to them in their classroom situation, but may have lost some of its original intent.
The primary setting
The ASSIST co-ordinator in this school was an experienced teacher, who had held a senior teacher post prior to the reorganisation of school management structures, and who saw behaviour as part of her remit. She had been approached by the head teacher as the most suitable candidate and had readily accepted the role. Most of the staff in the school were very well established; with the exception of a newly qualified teacher, and a new head teacher, who had been in post for just over a year. Consequently they were an experienced and stable staff, yet undergoing a period of change.
The school was a small rural primary, with just seven classes, and the staff described themselves as a close knit group, who discussed problems openly with each other. The sentiments of the P7 teacher below were representative of most of the interview sample.
We are a small and close staff and we do a lot of working together, if you like counseling each other, just as friends, you know. In that respect this school is very good……We do spend a lot of time talking about the children and discussing our own emotions and feelings and problems.
The isolation experienced by secondary teachers was not greatly in evidence in this primary school. It was widely acknowledged that some pupils caused a great deal of concern to staff, but staff appeared to respond by forming a cohesive and mutually supportive team, which fulfilled many of the intended functions of ASSIST. Consequently there was not the same need for a confidential service. Although staff cited the ASSIST co-ordinator as somebody with whom they would readily discuss behaviour issues, and whose advice they respected, discussions would take place openly within the staffroom, often with a wider group of colleagues. Generally, whilst staff were aware of the confidential service, and happy to know that they could seek out more personal support, in practice, only one member of staff had ever requested a confidential meeting, and the issue in question was not related to pupils' behaviour or wellbeing.
Given that most behaviour issues were not addressed in a one to one counselling session, it was rather more difficult for the co-ordinator to impress some of the other aspects of ASSIST on the teachers. In particular, there was little evidence of any structured solution-focussed approaches, and some teachers were not comfortable with the concept of removing their focus from the individual child, even though this would be seen by the development officer as being central to the approach.
The aspect of ASSIST that the primary staff were most familiar with was the environmental checklist, that had clearly been circulated for general use. The staff found it to be a useful reminder, when planning or evaluating their lessons, and appeared to refer to it quite regularly, although the items on the list were seen as a normal part of good practice. As the ASSIST co-ordinator commented:
Things on the checklist are things that teachers would do normally anyway, but having said that I think it is good to have the checklist because you do forget some very basic things that you could try.
The checklist was thus used proactively by staff on an individual basis, rather than being part of the toolkit used by the co-ordinator to support teachers who were reacting to problems. In this way ASSIST principles linking environmental management to behaviour were being embedded, or perhaps reinforced, in the daily structure of classroom. The links between ethos and behaviour were clearly understood, although without explicit mention of mental well being.
There seemed to be little conflict between the ASSIST approach and the wider school policies on tackling behaviour. Parallels were drawn between the challenges ASSIST poses to teachers to examine their own behaviour, and similar challenges that teachers pose to pupils:
I think it is part and parcel of the same thing. You ask the children to look at their behaviour, but you have to look at your own that might be causing the problem. So it is a two way process that goes hand in hand. The children are asked to look at why they have behaved like that, and then you have to look at if there is something in the class that made them behave like that, or something we could change, seating wise or whatever. (Teacher, female)
Essentially ASSIST was seen to complement or reinforce existing good practice in the school for dealing with low level disruption.
Discussion
Capacity building
The main purpose of the ASSIST scheme is to build the capacity of teaching staff to be able to respond competently and confidently to low level disruptive behaviour, through a reflective, solution focussed approach. By operating as a peer support system it engages teachers who may have had difficulties in addressing their problems through other mechanisms. But the self-selecting nature of referrals means that the scheme is only taken up by a proportion of the staff, and does not by any means reach all teaching staff. Some staff have demonstrated an active resistance to new ideas.
However, this is not necessarily a less efficient method of inculcating innovative thinking than the more traditional "top down" methods often used. Evidence from local authority interview data in this study, points to some of the limitations of using traditional "in service training" approaches to introduce new approaches. By using peer support in this way, communities of practice can be strengthened through targeted discussion and longer term intervention.
Whilst teachers were broadly in favour of the ASSIST scheme, and many could identify ways in which it had improved their confidence in their own classroom practice, they did not always appear to be cognisant of blame-free solution-focussed concepts. However they did feel up-skilled and more able to cope effectively with challenging behaviour, and, felt that the scheme was important for their own mental well being in terms of stress reduction.
Links between mental well being and behaviour
Implications in terms of pupil mental health were less well recognised by participants. Focus on the environment encouraged teachers to address school based issues which may have be damaging to mental well being, such as appropriate pedagogy, positive relationships and classroom management, but simultaneously discouraged consideration of any individual circumstances which might affect behaviour. It is important also to bear in mind the personal circumstances of children, which may have a bearing on behaviour, and to employ targeted strategies (stage 2 and above) where appropriate.
Additionally, the use of the checklist can encourage consideration of very mechanistic issues such as classroom routines, the physical comfort of the children, and does not encourage consideration of deeper issues such as relationships with the pupils, or empathy for vulnerable groups. Overemphasis on the check-list could reduce the ASSIST discussions to a technical exercise. Similarly the types of behaviours that are base-lined for the purposes of evaluation may be superficial manifestations of deeper issues. By concentrating on the frequency of quantifiable behaviours there is a danger that the teacher might overlook the more meaningful interpretation, for example the pupil appears to be bored, upset or socially isolated.
The ASSIST scheme is designed only to be used for low level disruption, and is not used to address withdrawn behaviour. Yet the school environment may in some cases be the cause of such behaviours, and a solution focussed approach may be very helpful in working with these young people. There is no reason why the ASSIST approach could not be used in these cases, but it would need to be rebranded. In general withdrawn pupils are not breaking any rules, and consequently, the association of ASSIST exclusively with discipline issues would need to be challenged, and its relevance broadened.
Evidence of effectiveness
Effectiveness of the ASSIST scheme could be analysed in several ways. Qualitative accounts of the users of the service certainly demonstrate that ASSIST can be effective in developing their capacity to address classroom indiscipline using environmental modification. For some teachers it has been a very effective support at a difficult time in their career. Aberdeenshire Council's own internal evaluation reports that 100% of staff who had used the service and filled in the questionnaire had found it useful. HMIe report "Inspection of the Education Functions of Local Authorities, Aberdeenshire Council (Jan 2005) states that "Staff involved with the programme reported that it was very effective" (p42).
Other indicators of change in schools where the programme is introduced, must be treated with caution. Schools are complex organisations that are constantly evolving, and any changes cannot be directly ascribed to the ASSIST programme alone. That said, Aberdeenshire Council report a consistent fall in exclusion rates in schools which have implemented ASSIST, and a significant improvement in ethos indicators.
The point at which ASSIST might be expected to have the most impact is the point of referral of pupils from level 1 to higher discipline levels in the school. If the ASSIST programme is increasing the capacity of teachers to respond effectively to low level behaviour issues, then this should be reflected in a reduction in the number of incidents that the teachers feel unable to cope with alone. As this is a confidential scheme, it is not possible to analyse this at the level of individual teachers, although a member of senior management reported he felt it was effective at individual level. The school was able to provide partial figures for discipline referrals (they were available for one house) showing a 26% fall in referral to senior management in the period August to January when comparing 2003 /2004 with 2004 / 2005. Whilst there could be a wide range of factors impacting on this improvement, not least of which would be the recent revamping of the schools discipline policy, it can be seen that ASSIST is part of a system in which discipline referrals are falling.
Sustainability
The ASSIST scheme is still relatively new in Aberdeenshire, and much work is still needed by the development officer before it is fully embedded within the structure of all schools. The current development officer is on a twenty three month secondment, and the sustainability certainly requires funding to be extended beyond this period. Once the roll out is complete, the scheme will require a level of central input to maintain the service, for example to train replacement co-ordinators when staff change, to support and update existing co-ordinators and to evaluate and develop practice.
Within schools the sustainability depends heavily upon the time management of the co-ordinator. Effective co-ordinators require time during the week to make themselves available to their colleagues. The local authority funds the initial setting up period, allowing supply cover to be bought in to cover the training period, but after the first year any time allocated to the scheme must be funded by the school. Consequently the success of the scheme depends partly on the priorities of the senior management team, in terms of budgeting for the school timetable, and also managing collegiate time. The development officer is currently in negotiations with head teachers regarding flexible time management for ASSIST.
Additionally the sustainability of the scheme depends upon the impact that the school co-ordinator can make upon the thinking of the staff. The personality and commitment of individual co-ordinators will have a significant role to play in ensuring the maintenance and development of the service. The philosophy of ASSIST involves a paradigm shift for some teachers, and may be seen as a threat by others, or may in some cases be met with disinterest. How the co-ordinator is able to meet those challenges in a school setting will impact heavily on the sustainability within the school. Changes of co-ordinator as staff move on could also threaten the sustainability, as trust gained and professional respect will need to be re-established by the new comer. There is clearly an ongoing role for the development officer to support the continuation of ASSIST within the schools.
Summary: strengths and challenges
- The ASSIST scheme develops the capacity of teaching staff, and therefore the capacity of the school as a whole to respond effectively to low level disruption. It introduces solution-focussed, blame-free methods of dealing with issues, that may in some cases act as early intervention, deflecting situations away from more serious disciplinary incidents. It focuses on the links between the school environment and behaviour; an approach which implicitly acknowledges the effect of the school environment on mental well being.
- It is based on a clear understanding of the sensitivity that teachers can feel about admitting to discipline problems, which is by addressed by offering a confidential service, which allows teachers to tackle their difficulties without compromising their standing with colleagues or managers.
- ASSIST also recognises the tendency of teachers to develop their practice through personal experience coupled with informal learning from their peers. By positing the ASSIST co-ordinator as a respected colleague, with whom teachers can discuss their own classroom tactics the scheme encourages this type of community learning, for those who are feeling isolated by their problems. In this study, it appeared that this type of mutual support was already very much in existence for the whole staff, in the primary school and there was not the same need for a formal mechanism of accessing peer support.
- The sustainability of the scheme depends upon the time available to the development officer and to the school co-ordinators. Currently both are in short supply, and if a new way of working with pupils is to be widely introduced into schools it may require greater commitment of resources. Additionally the solution focussed environmental approach is currently being offered only to those experiencing difficulties, and if it is to be embedded in the school system it would require wider dissemination, coupled with a commitment from staff to engage with the approach.
- Currently ASSIST is viewed by staff largely as a means of addressing their own mental well being, which is in itself very important. The environmental methodology could be linked much more explicitly to the mental well being of pupils, and could also be developed to include consideration of pupils whose behaviour causes concern for matters other than indiscipline, notably those who are very withdrawn or isolated.
Case Study 2: East Renfrewshire, multi-disciplinary support team, based at Woodfarm High cluster.
This case study focused on a multi-agency Integrated Community School team based within one of the school clusters in East Renfrewshire. (Field work was conducted in the Woodfarm High and one of its feeder primaries, Thornliebank School) This structure was selected for case study as it was a well-established team, and it particularly focused on mental well being by the inclusion of a youth counsellor, employed by Renfrewshire Association for Mental Health ( RAMH). Additionally issues of emotional well being in the school and the community were addressed by a social worker and two family learning co-ordinators, one of whom worked exclusively with the black and ethnic minority community. Other workers such as the active primary schools co-ordinator, the health co-ordinator and the careers officer had roles which impacted upon mental well being to some extent. A range of proactive and reactive strategies were employed by members of the team.
Funding sources of the posts were varied. The team was managed by a single integration manager with individual workers also jointly supervised by their respective services. Head teachers had no direct managerial control over the team, so consequently the team provided a locus for collaboration between a range of services.
This school cluster was the East Renfrewshire flagship of the integrated community school roll-out, having been the original pilot, and having developed, what was widely perceived to be, a successful model of working. Although this school was not in the most deprived area of the authority, it had been selected as the pilot due to the high levels of deprivation amongst its families (many of whom lived in a very poor area of a neighbouring authority), its ethnic mix and its ineligibility for additional resources from SIP funding. (Although it was an area of deprivation, it had not benefited from SIP funding and had not had the opportunity to develop the associated social inclusion initiatives). The project began in August 1999 with the appointment of the integration manager. The commitment of the local authority to ICS working was evident both in the prompt implementation and in the methods of funding. Those staff who were employed by East Renfrewshire Council were on permanent contracts (the exceptions being the youth counsellor and the active schools co-ordinator).
Thornliebank Primary School was highly committed to supporting the wellbeing of pupils and their families. Interviewees, including parents, classroom assistants and ICS team members attributed much of the caring culture of the school to the attitude of the head teacher, who summed up her feelings about the ICS in the following way:
I see the difficulties our families have through poverty, through substance and alcohol misuse, through lack of literacy. And I find it very frustrating that in many schools they don't take account of the background of the children and I just saw the pilot of being a community school as being the way forward, so perhaps I embraced this with open arms in a way that maybe other head teachers may or may not do.
She saw her remit as extending beyond education into the wider community and supported a wide range of activities to enable this, as exemplified by the following comments:
I don't see this school as a centre for education, I see [the school] as a centre of the community.
The children are at the heart of every thing, but I don't see my job exclusively as children and I do not see my job exclusively as education.
The primary school was involved in a project entitled "Community Well Being" funded for two years by the National Programme for Improving Mental Health and Well Being. The family Learning Co-ordinator was seconded to fill this post. The ICS Integration manager described the aims of the project:
It's about sustainability, but its also about changing attitudes and dispositions towards the whole notion of mental health and well being, and also towards the integrated community school being more than the teaching processes and what happens in the classroom, but also about how the school responds to the needs of its community on a 52 week basis…... And it involves the whole notion that the family come together to do something so its building….building the family unit, hopefully its resilient unit which can do things for itself but also building a larger unit, sort of community groups.
Prior to being awarded this funding, the school had already begun to develop firm links with the community, but had not identified the implications of this type of work for mental health, as described here:
One of the reasons that they funded us to do this was because they had done some research on community well being, again it was the Scottish Development Centre for Mental Health, that had done that for the national programme and they had come and looked at what we were doing here. And then they set about funding these what they call National Exemplar programmes because they reckoned that we had good practice here. And they reckoned that we had good practice in mental health which was something that we hadn't actually identified as being mental health.
The secondary school with its roll of 718 pupils was also proactive in its to support of the well being of pupils, in a number of ways, and this was particularly evident in its' extra curricular provision. The HMIe report (2002) commented on the strong identification that pupils had with the school, and this was confirmed by our interviews with pupils. The opportunities available through the very extensive extra-curricular programme featured very largely in the pupils' accounts of school. Not only did they provide fun and interest, they also were vehicles for forming and maintaining friendships, they enhanced relationships with staff, and in some cases they provided a refuge from more difficult lives outside school.
You can make loads of friends in certain clubs. The dance club, almost every girl in second year goes to the dance club. So it's a great social place because we have a laugh as well. (S2 girl)
The pastoral system was well developed in the school; the young people were confident in the support they could access from the pupils support team (previously guidance), and this aspect of the school had also been commented upon by the HMIe. The integration manager of the ICS (who was not an employee of the school) made the following comment about the pastoral care in the school:
I think [the secondary school] is quite outstanding in the way it has reduced its exclusion. And it's dealing very well in a pastoral way with its youngsters and working very well with other agencies. But the interesting thing is it's holding that, and at the same time its attainments are going up……So [the school] among its sort of national peers is very high and they know that. Yet they can do that at the same time do all the social inclusion things.
These two schools in which the ICS team was based both, in different ways, offered a culture of concern for the well being of pupils which the ICS team was able to enhance.
Targeted support for vulnerable pupils was provided, individually and for groups, by the social worker, the counsellor and the careers officer, with a self referral service offered by the school counsellor. Additionally a strong emphasis was placed on community and family support, including universal provision in the form of activities organised by the family learning co-ordinator, and targeted interventions by the social worker, and the family learning co-ordinators (including the black and ethnic minority family learning co-ordinator).
Multi-agency working
The success of the team depended upon effective multi-agency working in both policy and practice. There was ample evidence of effective working between the different agencies of the support team. Co-operation through the Joint Support Team meetings, joint working with groups of pupils, formal and informal discussions were all examples of co-operative working. Team members described the synergism of this type of working, with each being able to enhance their effectiveness by collaboration.
The youth counsellor expounded the value of joint working in the following way
My experience has been how hugely beneficial it is for example to have a social worker in the school, massively beneficial but it helps my job tremendously because you have instant access to that knowledge, to that experience, instead of going down the route of "oh let's go to the panel". Again careers, exactly the same. Some of the issues that young people bring are around "what am I going to do? I have no direction, where am I going?". I don't know how to do this, so having access to the careers worker is again vital. And [the attendance officer], …… you know co-working with [her]in relation to some of the kids who have difficulties who aren't attending is again hugely beneficial.
It was also felt that a joint approach necessarily led to a more open and visible way of working.
New members joining the team, for example the Active Schools Co-ordinator were able to build on the ground work done by the family learning co-ordinators in identifying and approaching target families.
The teams also demonstrated effective collaborative work with school staff particularly at managerial level, and with the pastoral staff. Their input at JST meetings was considered essential, and their role in implementing the support identified at the meetings was also crucial. Whilst this work was largely supporting pupils and families the teams also had some input on the curriculum, particularly PSE in the secondary school, and a reading scheme in the primary school.
Whilst the team had close links with key educationalists, they had much less impact on the school staff as a whole, in either school. Generally staff concerns about pupils would be referred to senior management or support staff, who would, in turn, liase with the interagency team. Relations between the team and the remainder of the teaching staff were minimal. The staff saw the role of the support team as separate from their own role; they were pleased that the school now had mechanisms to support vulnerable pupils, but in general they did not interact directly with the team over individual pupils, nor did they feel that they as classroom teachers were also members of an inter-agency team.
Access to services
A critical aspect of the service provision is the procedures by which pupils are identified and gain access to the support system. In both primary and secondary schools referral was largely made by the teaching staff, through the formal procedures of pupils support and discipline, and in some cases also through the JST system. The majority of cases were reported as being those pupils who were "acting out", causing the type of disruption that impedes successful delivery of the curriculum. The system was less sensitive to pupils whose behaviour was quiet and withdrawn, for the reasons described by this teacher:
Yes, these [withdrawn pupils] are the ones that are much, much harder to deal with; in some ways these children are behaving as you would ask them to behave. They are being quiet and they are being good and they are appearing to get on with it. And these are the ones who, the danger is, they may very well slip through the net, that they won't be noticed. (secondary male teacher)
An option of self referral was available in the secondary school through the youth counsellor, which could potentially draw in young people whose issues went unnoticed by the adults in the school, but only 10% of pupils using the service were self referred and the counsellor herself expressed doubts that socially isolated and vulnerable pupils would feel able to come forward of their own accord. So there remained potential for a more sophisticated system of identification in the school.
Parental access to services tended to be mediated by school staff. In the first instance their concerns would usually be articulated to the head teacher in the primary school, or to guidance staff in the secondary school, who could make referrals to specialist staff. If the case was deemed sufficiently serious to merit a JST meeting, parents' permission was sought before such a discussion was held, but in most cases the meeting was conducted in the absence of the parents who were informed afterwards of the appropriate course of action that had been chosen.
So it can be seen that the system remains very much in the control of the professionals, who act as gatekeepers to the services, and that the main stakeholders, the pupils and the parents, are less active in the process of referral and choice of action. Their main control of the process is the option of veto.
Capacity building
The team had undoubtedly enhanced the capacity of the schools to support pupils with mental health issues through a variety of targeted and universal approaches. Many issues were readily identified and responses could be rapid, and flexible, meeting needs as they arose.
One of the main successes of the team was perceived to be the maintaining of some pupils in school who might otherwise not have been able to cope. Paradoxically, in some ways the successful inclusion strategies of the team had increased the challenges faced by classroom teachers as they were required to meet the needs of a wider range of pupils. One senior manager described the dilemma the school faced:
It's hard when you are a classroom teacher, then you may well think "Why are we having to put up with people with such obvious difficulties?" And maybe they don't see their support is being particularly effective. Whereas the fact that we have actually got her in school and staying is a success, but that doesn't necessarily transfer to the person in the classroom. And I don't know the way round that one. It's a very difficult one.
The teams had not yet exploited their potential for building the capacity of the wider teaching staff to understand and respond appropriately to issues of mental well being in their classrooms. The expertise held by these workers was not readily transmitted to the teaching staff through either formal or informal means. Generally they were seen as quite separate from the teaching staff, providing a valuable supporting role that allowed teachers to concentrate on the curriculum, but they were not widely recognised as a resource to enhance capability.
The youth counsellor, in particular had a remit for training of staff in mental health awareness, but there were various structural barriers to this occurring widely on either a formal or an informal basis. The lack of daily contact with many of the staff, partly due to different location, and different break times, were an obstacle to collegiate relationships between the multi-agency team and the professionals and teachers. Also the support framework that teachers chose to access tended to be other teachers; interviewees were most likely to refer to teaching colleagues about strategies for working with pupils.
Early attempts to deliver short whole school in-service training sessions were not viewed as very successful, and some staff had expressed doubts about the validity of advice from someone without the practical experience of classroom management. Given the concerns stated by staff that they were increasingly expected to work with children whose behaviour they found challenging, there seemed to be very good reason to consolidate the training and support links between the interagency team and the teachers, but this area of work was still in its infancy.
Sustainability
The interagency team had over the past five years not only sustained its original form and functions, it had extended to take on more workers and wider remits. The sustainability can be seen to be due to two major factors. Firstly, East Renfrewshire Council's policy to employ all workers on permanent contracts enabled the team to work with confidence and commitment to the schools. Whilst permanent contracts do not guarantee the future of the ICS team, as workers could be redeployed to other posts in the authority, it does mean that the workers are financially secure, and hence are less likely to be attracted to other longer term positions. Consequently the schools have had the benefit of the full attention of a fairly stable team throughout its existence.
Secondly the sustainability of the scheme is a measure of the success of the team. Both schools had developed very firm relationships with the teams and the work of the team was by now firmly embedded in the framework of the schools. Once in place the team provided a structure through which new workers could be introduced to the schools. The existing knowledge and relationships provided a platform from which new initiatives could be launched. So the team was not only sustainable, it provided for growth and development.
The Home / School interface
As the Integrated Community School moves towards providing interagency support for the child, within the wider context of the family and the community, the boundaries of responsibility are inevitably shifting, with the school moving into areas that were traditionally seem as the domain of the family. This also implicitly and explicitly has implications for parents as they are guided towards what the school perceives to be better parenting practice.
The social worker's loosely defined role, as a "non statutory worker", where there was no legal obligation on the part of the users or the providers of the service, offered an interesting new interface between school and family. The social worker's self defined role, to be helpful wherever she could, was open to a range of interpretations, which were not clearly bounded by any guidelines. It did however, offer a very flexible approach, to meeting needs that had been identified by the school, the family or the pupils themselves. The non-statutory nature of the work allowed families to opt out if they did feel her intervention was inappropriate. Although this type of relationship was novel, there was no indication that it was seen as problematic by any of the parties involved, and it appeared that her support had been offered in ways which were welcomed and deemed appropriate by the families involved.
The role of the family learning co-ordinators similarly broke new ground with respect to the home / school relationship. The main aim of this post was to encourage parents to become more involved with their children's education and well being. Inclusion of minority groups in this initiative was prioritised by the appointment of a black and ethnic minorities family learning co-ordinator, whose personal background and experience allowed her to act as an effective intermediary between the school and home.
An important aspect of the development of home school partnership took place under the banner of the "Community Well Being" initiative. Having acknowledged the ineffectiveness of traditional "parenting workshops" or "literacy workshops" the family learning co-ordinator drew the family into the school community by running a wide range of holiday time activities, which were heavily staffed and offered activities for both children and their parents. Parents spoke very warmly of the impact this had on their own well being, of forming friendships, of reducing isolation and of providing a forum for discussion their children with other parents, as illustrated in the comments below:
You get talking to all the other parents and you find out how they are feeling about their children and it gets you understanding more.
You are mixing with other people you wouldn't normally see, its great fun.
You don't see parents arguing you see them laughing and joking and getting on. And if the parents can do that it's a good role model for the children as well.
The schemes were very well used, although the school acknowledged that there were still parents in the community who maintained minimal contact with the school. The activities benefited the school as they forged closer links with the participating parents, and generally built mutual feelings of goodwill and trust.
Another significant strand of this worker's role was to organise a very active home reading scheme, whereby books went home nightly, from nursery school age. Relationships with parents were maintained through this scheme as notes were exchanged continually between the worker and the parents.
The family learning co-ordinator also responded reactively to families experiencing difficulties and provided a flexible and practical support ranging from transport to school to befriending. This individualised, responsive service was highly appreciated by parents.
You can always talk to H and get support there. They were very good about my husband. He had a heart bypass two years ago. They were always asking how things were, do you need any help and H was going to come by my house and pick my son up and bring him to school. He's always ready to help. And that goes for anybody.
At the heart of this scheme is a belief in the value of expanding the remit of the school to include community responsibility, to build the capacity of families and the whole community, through participation and targeted support. That the integrated community school staff feel a sense of frustration at failing to engage with some parents, is an indication of the reach that the school feels it should have into the wider community. To some extent this highlights the tensions between the public duties of schools and the private sphere of the family, and how the boundaries are drawn between the two.
Summary: Strengths and challenges
- This model of working has imported a varied team of workers to develop the capacity of the school to address issues of well being at individual, family and community levels. There is a well-established team of workers who collaborate effectively with each other and with the managers and pastoral care staff in the schools. The model has demonstrated its sustainability and has acted as a foundation for later expansions of role. Mental well being is supported proactively and reactively through a range of universal and targeted activities and interventions.
- Particularly in the primary school, efforts are made to involve families in a wide range of community activities, through the family learning co-ordinator. However, parents are not fully involved in the identification of difficulties or the determination of the best course of action, in the case of targeted interventions.
- Whilst the presence of the team has undoubtedly enhanced the capacity of the schools to respond to issues relating to mental and emotional well being, leading to more successful inclusion of some pupils, this has led, in some cases to class teachers being required to work with pupils whose behaviour they find very challenging. The links between the interagency teams and the classroom teachers are limited, and the capacity of the teachers to understand and respond to these issues has not necessarily benefited from the presence of these workers in the school.
- Those pupils most likely to come to the attention of the interagency team are those whose presence is most noticeable in the school setting, through their disruptive behaviour. It was widely acknowledged that pupils whose mental health difficulties caused them to become withdrawn were more likely to be overlooked. Sensitive mechanisms of detection, coupled with highly accessible self referral services need to be developed.
Case Study 3: The Place2Be
The Place2Be is a UK based charity dedicated to providing therapeutic and emotional support to children in primary schools. The first two schools in Scotland to host The Place2Be services were the subjects of this case study. Both are Edinburgh based schools, located in areas of deprivation.
The Place2Be is a voluntary sector organisation offering a health related service within an educational setting, so sits strategically between these three sectors. Funding for these pilot schemes was provided jointly from four sources, reflecting these different interests: Scottish Executive, Edinburgh City Council, Lothian Health Board and the schools themselves.
Within the schools The Place2Be offers two main services to children: The Place2Talk and The Place2Be. The Place2Talk is a universal self-referral counselling service, offering pupils the opportunity to discuss anything which causes them concern. The Place2Be is a targeted therapeutic service offering one-to -one and group work sessions to pupils who have been referred to the service, usually by the school. Additionally there is the possibility of offering a capacity building service for teachers called The Place2Think, although this service is currently less well developed in the schools under study
Nationally, The Place2Be is a rapidly growing organisation, which was founded in England in 1994, and in 2004 was working in 92 schools throughout the UK. It is a highly structured organisation, managed as "hubs" within specific locations. Currently there are five hubs in the UK, one of which is Edinburgh. Each school is the responsibility of a school project manager, who reports to the hub manager. Regular contact with the regional manager keeps the schools and the hubs in close contact with the national managers. Consequently the The Place2Be offers a consistency of approach across the country. Internal evaluations in the form of annual analysis of strength and difficulties questionnaires are used as a measure of quality control.
Within the schools The Place2Be operates within its own space; a designated room is provided by the school to be used exclusively by the team. Only the schools project manager is a paid employee, the rest of the service is provided by trained volunteers. Mainly volunteers are students of therapeutic disciplines, and their work with Place2Be forms a placement as part of their course. As a result Place2Be operates on an annual cycle and this impacts on the patterns of support offered to pupils.
Stakeholder involvement
A significant feature of The Place2Be was its accessibility to the main users, the children. The service placed itself, very successfully, at the heart of the school, in the eyes of the children. As expressed by the chief executive of The Place2Be, this was a key aspect of their strategy:
People say "what's the success due to?" I think its because we are there and we are accessible and we are familiar and we are consistent, and they see us there at the same times and the same places….so it's a known factor so it doesn't feel like something strange and external to their daily lives.
The Place2Talk was very popular with the children and drew in a large number of pupils for a wide range of reasons, many of which would be seemingly trivial to a busy adult. The designated room was described by the children as being a comfortable, friendly and fun space in the school. By taking all children's concerns seriously and treating them confidentially, The Place2Talk developed an important relationship with the pupil population of the school, which was highly valued by the children who were confident they would be listened to by a friendly, non judgmental adult. They frequently contrasted the responses of The Place2Be staff with those of other adults:
Sometimes the teacher mentions it to the whole class, [the schools project manager] only keeps it to herself. She keeps it as a little secret between her and the person
If teachers are really annoyed they start shouting at you, in here they are patient with you
Teachers don't really have time sit and listen, and they [The Place2Be staff] have time for you
Pupils reported no barriers to approaching The Place2Talk for anything they deemed to be important. As the service was readily used for both low level and more difficult problems, there was no stigma attached to going; by electing to visit Place2Talk, a pupil was not identifying themselves publicly as having any particularly serious issue. So, it provided a very accessible service, which had the time to support pupils with minor issues but also provided an important avenue through which more serious issues such as playground conflict, family disharmony, bereavement, or problems in relationships with teachers could be identified.
Pupils were not only valued in the identification process, they were also the key players in determining the response. Matters were only taken out of the child's control in cases where child protection was thought to be an issue. Targeted therapeutic sessions were child led; the counsellor' thinking and approach were informed by what the child brought to the session. A range options of expressive activities were on offer for therapeutic work, including art, drama (through puppets), and writing. Pupils were free to choose which activity, if any, they wished to take part in, and it is through these media that the workers explored issues with the children. One child described his experience of attending The Place2Be therapy:
I went to Place2Be and I thought it was brilliant and it was fun because I could play. It takes your mind off things for a wee while.
Whilst another commented:
You can step in and you're all sad and you step out and you're all happy. It's like the magic room.
Parental involvement in The Place2Be depended upon the level of service which the child was accessing. For The Place2Talk, the parents were annually informed of the presence of the services in the school and given the option of "negative consent", in other words their permission for their child to self refer was taken for granted unless they actively refused. It was very unusual for parents to refuse to allow their children to take part.
For the more intensive therapeutic sessions, parental involvement was valued by The Place2Be. Their permission was sought at the outset and they were required to fill in a "strengths and difficulties questionnaire", as a minimum involvement. There were also opportunities to meet with The Place2Be staff during the intervention and to be involved in the final assessment. The content of the sessions remained confidential, unless the child agreed that parents were informed of issues. Whilst The Place2Be encouraged parental involvement, there were a minority of cases where parents never responded to requests to work with pupils due, it was felt to the parents own difficulties and chaotic lifestyles. In these cases The Place2Be was unable to support the children involved.
Parents expressed mixed feelings about their children accessing the service, particularly The Place2Talk as identified by this mother whose son had confided in a worker:
In a way I was a wee bit disappointed because he never came to me, but in another way I was happy that there was somewhere like that where children can go.
Whilst some identified their own shortage of time to listen carefully to their children, and valued the alternative support, there was also a sense that one of their functions as parents had been appropriated, that their children might now communicate with them less about important issues. Some parents also felt uneasy at the prospect of family issues being discussed without their knowledge.
Things like marriage breaking up, these are big things that can really affect the child. If I was in the middle of breaking up with my wife I don't think I'd want [my daughter] coming in here.
But overall the value of The Place2Be was recognised by the parents we interviewed, who were pleased that there was an additional level of support available for their children, and understood the importance of The Place2Be for the most vulnerable children in their community.
Interagency working and capacity building
The success of The Place2Be within any school depended heavily on successful interagency working between the school staff and The Place2Be staff. Schools which entered into partnership with The Place2Be were initially self selecting; in the case of the two Edinburgh schools the head teachers had expressed their interest in the scheme after attending a presentation. Additionally, The Place2Be carries out an initial assessment of suitability, which includes some account of existing school attitudes. So The Place2Be sets up in schools which are already predisposed to concerns about mental well being of pupils, and which identify themselves as being able to benefit from such a service. Care is taken during the induction into schools which is a gradual process, taking up to a term to introduce the service to staff, parents and pupils before the service is fully operational. Teachers within the schools were supportive of the project, often being able to cite examples of pupils for whom there had evidently been marked improvements in their mental well being. They also spoke of feelings of relief that there was some other support for pupils about whom they had serious concerns but neither the time nor the expertise to deal with fully themselves. As with other case studies, there was an indirect link to teacher well being, as The Place2Be removed some stresses from the class teachers.
The relationship between the school and The Place2Be was very much defined by the latter party, who laid down very clear working practices and relationships before any partnership agreement was reached. The Place2Be depends heavily on schools to make referrals for targeted therapy, and draws as much information as possible about individual children during the referral process and during the ongoing intervention. However the flow of information is very much one way; The Place2Be impose very strict boundaries around the confidentiality of their work, whilst drawing on the observations and insights of those around them. Both teachers and volunteers were acutely aware of the limitations to conversations that they could hold about pupils, with teachers feeling inhibited to ask detailed questions and volunteers practised in non-specific responses. One teacher described her impression of a recent conversation with a The Place2Be counsellor about a child:
There was a lot of talking in metaphors, shall we say, and vague references to things that were said. And I didn't get a clear picture.
This was a significant point of concern for some teachers who felt that they would like to be better informed about the difficulties faced by pupils in their charge. The Place2Be subsumes some of the role which was traditionally the domain of the teacher, that of listening to pupil's problems. Whilst The Place2Be has the capacity do perform this role for the pupils in a highly focussed and effective way (which is the reason in was introduced to the school), it deprives the teacher of some of the knowledge she might otherwise have held about the pupil. Concerns were expressed about the impact that the lack of information could have on the teachers' relationships with certain children:
You sometimes feel very left out because you could be handling a child completely wrongly if you don't know what is going on
Teachers' concerns over this related to their ability to respond appropriately to the needs of vulnerable pupils. So a tension was identified between protecting the privacy of pupils and sharing information in a way that would enable teachers to work effectively with the children.
One of the aims of Place2Be, which was not yet fully realised in the Scottish schools was described in the Place2Be information pack: "Can provide training to build increased capability amongst the school workforce to identify and address emotional issues". One way in which this operated was through Circle time. By invitation, the schools project manager would jointly run a circle time session with a class, focussing on a significant issue for the group, possibly relating to friendship or bullying. This level of involvement acted as an informal method of training teachers in the circle time methodology and gave them brief insight into some emotional issues. No formal training had yet been offered, in the case study schools but there was a service for staff called The Place2Think, whereby staff were invited to work with the schools project manager, formally or informally, to discuss matters, of concern to them, which related to mental health of pupils. Staff interviewed seemed largely unaware of this service, and only in one case had an interviewee approached The Place2Be on her own behalf. The Place2Be staff recognised this as an area for development in these schools, and saw their current situation as a natural stage in the embedding process.
Lying at the very heart of The Place2Be philosophy was a paradox between the need to be embedded within the structure of the school, and the need to maintain an independent existence as a confidential service, as outlined below:
We never forget that we are hosted by the school and in a sense we have guest status, no matter how integrated we are. Because of the therapeutic confidentiality we always have to have enough separateness to be separate, but enough integration to be working closely with the staff team (Hub manager)
Whilst The Place2Be was certainly seen by pupils as a completely integral part of the school structure, its slightly contradictory position gave rise to some ambivalence in relationships with the professional school population.
Links between behaviour and mental well being
Mental and emotional well being were very explicitly the main purpose of the work of The Place2Be. Whilst the stated aims of the organisation were not specifically associated with behaviour, in reality, those pupils who were referred to the targeted therapeutic interventions were mainly identified by some aspect of their behaviour which was deemed to be a cause for concern, whether it was withdrawn or disruptive. The Place2Be staff were quite clear that they did not offer a behaviour management service. Although they were quite willing to work with disruptive pupils to address the underlying issues, they were not prepared to focus on the behaviour itself, seeing this solely as an indicator.
Places for one-to-one therapeutic support were limited by the available volunteers, and the time spent in each school (the two schools studied shared a single manager, so The Place2Be operated only half a week in each), there being eleven places in each school. Pupils who were allocated these places were carefully selected against a range of criteria, including whether they would benefit from one-to-one or group work. Pupils themselves were not part of the referral process, (although their disclosures at The Place2Talk may have given rise to concern) and were sometimes surprised to be given a place, and unaware of reasons for referral. Reasons for referral to the intensive therapy were varied but in both schools it was reported that the pupils who were allocated places were predominantly boys whose behaviour was unmanageable in class. However, the teachers' observation of these cases was that The Place2Be was least successful when working with disruptive pupils. The best results, in the eyes of the teachers, were with the more withdrawn types of pupils, as described here by a depute headteacher:
The biggest impact I think has been on the sad kids, the lonely kids, the kids who don't have any friends, the ones who get picked on, bullied, the ones whose home life is a wee bit sad really. ..And part of what it does is it gives those children someone to talk to and it makes them feel special because they do get to be withdrawn [from class], and they get to do lovely art or drama, whatever it is. And they have their portfolio and they do feel quite special, and when you are somebody who has never been made to feel special, in fact when quite a lot of the time you have been made to feel fairly crap and worthless that impact is huge.
However, it should be borne in mind this is the school's view based on behavioural observations, and that the pupils, parents and The Place2Be staff may take another view of the differences that The Place2Be has made for those disruptive children.
Evidence of effectiveness
Whilst the management of both schools were strongly in favour of The Place2Be and keen to maintain its presence within the school, they found it difficult to provide any concrete indicators of effectiveness. Uptake of the service was mentioned, but this in itself is not an indicator of successful outcomes. Evidence was provided in terms of individual cases in which the interventions had created a marked effect on the pupils behaviour, usually in terms of self esteem and emotional literacy, or where support had been available at a critical moment for example during a bereavement. These are intangible effects from which it is difficult to draw firm conclusions. Even those pupils whose attendance had improved markedly as a result of The Place2Be were such a small proportion of the total school population that they would not significantly affect the overall figures. ThePlace2Be themselves conduct an internal audit, based on strengths and difficulties as perceived by pupils, teachers and parents, and from this would identify an improvement in the emotional health of their clients, as a group. However, even this data cannot conclusively point to the cause of such improvements being The Place2Be.
As with other case studies, whilst The Place2Be was very widely viewed as an effective service, the complexity of the issues with which they deal makes it difficult to identify meaningful indicators. Some of the most compelling evidence for the value of the service came from teachers who described the pleasure which their vulnerable pupils gained from their weekly sessions, how keenly they looked forward to their hour of being special, which for some, it was felt was their only experience of such attention.
Summary: Strengths and challenges
- The Place2Be offers a child-centred therapeutic service to support the mental health of pupils in primary schools. It appears to be most effective in supporting pupils whose difficulties are expressed as withdrawn, socially isolated behaviour, and is not seen as an effective service for correcting disruptive or aggressive behaviour (nor is it intended to be).
- It offers a service which is very accessible to its main users, the children. Pupils see The Place2Be as an integral part of the school.
- Whilst parents largely supported the presence of The Place2Be in the school, and particularly identified its importance to the more vulnerable members of the school community, some expressed ambivalence as they could see an encroachment upon their parental role.
- Teachers and school managers were highly appreciative of the support available for the pupils, and identified an associated reduction in their own stress. The Place2Be had not yet developed effective strategies in the Edinburgh schools for increasing teachers' own capacity to respond effectively to pupils mental issues, but were hoping to expand their training and consultation roles in the future.
- At the very heart of The Place2Be lies a tension between the need to integrate fully with the school, and the need to maintain its independent operations, bounded by strict codes of confidentiality.
Case Study 4 - Newbattle New Community School Team
Introduction
This case study explores the work of the Newbattle New Community School Team. (This was later renamed the Newbattle Integrated Community School and we refer to it as the ICS team). The team originated as a new community school in the Scottish pilot in 1998 and continued to receive funding from this source for the duration of the programme. A feature of this initiative was a capacity to weave in additional sources of funding and expertise to enhance the work on mental and emotional wellbeing. Thus the Changing Childrens Services budget contributed to mainstreaming of the posts and the model was subsequently adopted for four integrated teams working with all schools in Mid-Lothian. A health drop-in centre for young people (the Ozone) was initiated in NCS in 2002 with additional funding from Healthy Respect, a four year demonstration project on sexual health funded by the Scottish Executive Health Department. In addition the team took part in the national Communities that Care initiative which was supported by the Joseph Rowntree Foundation. This programme derived from a US experiment and sought to engage communities themselves in firstly identifying risks that they faced and secondly in exploring ways that plans could be developed to tackle these risks. Although this did not have a specific health focus, the mental and emotional wellbeing of parents and young people assumed a high profile.
This project was selected as a case study for five reasons:
- partnership was a key element of the approach
- the promotion of health and emotional wellbeing was central to the initiative
- the work had taken place over a seven year period with a relatively stable staff team.
- the ICS appeared to be well embedded not just in the ethos of the school but with professionals, young people and parents in the area.
- the work took place at strategic, group and individual levels
The new community school team
The Newbattle High School cluster catchment includes recognised areas of substantial material deprivation and educational disadvantage. The cluster includes the areas of Mayfield, Newtongrange, Gorebridge Temple and Borthwick. One denominational primary and one secondary are also sited in the area but fall into a separate catchment area but some work on emotional and mental wellbeing is undertaken with these schools. Key concerns around mental and emotional wellbeing that were identified by parents in a consultation exercise included bullying, teenage pregnancy, bereavement, drug and alcohol misuse (Macaskill, 2001).
The aim of the new community school team is 'to provide integrated service provision for children and families at risk and who experience difficulties in school' and to build a team of professionals around a group of schools (Midlothian Council, NCS Phase 2 application, 2002).
The integration manager oversees the work of the core team and manages two family support workers, a social worker, a community education worker and a health worker and a team of part time staff. In addition she works with an extended team which includes a behaviour support teacher, an educational psychologist, community police representative, and education welfare officer. The integration manager is accountable to the Director of Education and is a member of the senior management group of the high school. A school nurse is heavily involved in the drop in service and in developing programmes alongside the health worker, external agencies and teaching staff. Midlothian Young People's Advisory Service (hereafter MYPAS) a voluntary youth counselling service took over management responsibility for the drop-in in 2004 in addition to their counselling work with young people. Other voluntary organisations are also involved in the work of the ICS. The head teacher is highly supportive of the work of the integrated team and the work is strongly linked with the guidance team. A deliberate decision was made to base the core team in premises away from the school campus.
The approach
A wide range of initiatives and interventions characterise the work of the integration team and these operate at whole school, year group, small group and individual levels. The ICS manager believed that many of the risk indicators for poor mental health were a feature of the area and that these were linked to high levels of material deprivation and poor emotional wellbeing. She felt that the work of the team took a holistic approach,
..it was also a recognition that emotional wellbeing in its widest sense affects all sorts of things in people's lives - so there are the low level mental health issues which we come across all the time …..But it was rather an idea that promoting emotional wellbeing was going to have a much greater effect than just dealing with mental illness ( ICS Interview)
Within the NCS recognition of the role of support staff was made by the head of guidance and the approach attempted to build on this,
The other thing in here and I don't know if this is common to other schools ..I mean it is not just the teachers - the office staff are all very good. There is a whole band of classroom assistants around that have very good relationships with young people and as [the health worker] says there is the Ozone (drop in centre) so there is a range of people that they can build relationships with. There is a lot of afterschool activity as well so youngsters are relating to staff in a different way and all of that just builds up general strength of support if you like (Deputy Head, Guidance)
Although there was general enthusiasm about the approach, some uncertainty had been expressed at the outset about the development. However those interviewed in general felt that there was now more acceptance of the benefits of the additional resources brought in by the various initiatives based in Newbattle.
Capacity Building
Training and capacity building were an important feature of the work and this took place at a range of levels and with different groups of stakeholders. Thus professionals, parents, young people and school staff were included in the capacity building work in significant ways.
The health promoting school group was targeted at all schools in the Newbattle Cluster and was viewed as a key mechanism for drawing professionals into partnership work on health generally. This was an early initiative based on the WHO definition of the health promoting school and although the concept was viewed as vague and poorly worked out, it offered a means of 'galvanising' the schools involved and linking them with the new community school pilot. Professionals were enthusiastic about this group which included school nurses, teaching staff, health visitors, school catering service and sports workers. A survey of health education across the area took place at an early stage and set out to assess what was being taught in schools, where common areas existed, where gaps lay and where duplication was taking place. A review which took place two years into the work identified emotional wellbeing to be a priority issue.
We have tried to do as much training as we can around mental and emotional wellbeing so that we can build capacity to deal with that. We were very excited last year though nothing has come of it - there was to be a cluster identified to look at emotional intelligence across the cluster and we had said that we would be very keen to do that (Manager).
Communication about the work was undertaken through a variety of means including meetings at a strategic level. This was felt to be important in signalling the high priority of this work,
There is a monthly cluster meeting of all the heads …so there is discussion of all these issues on a monthly basis (Depute)
An annual conference is organised for staff to get together from all the sectors to explore a particular issue and efforts are made to include a wellbeing element for participants. The annual conference attempts to act as a springboard for work that continues throughout the year.
Staff training was organised by the health worker on topics such as mental health and young people, self harming and eating disorders. These courses were based on the twin aims of raising awareness of the issues and offering the opportunity for interagency working and networking. She believed that the latter was particularly important for teachers. Although teachers took up about 50% of the places, she felt that timing of the courses was critical to avoid expensive staff cover costs and to take account of the pressures on their time. A course on mental health and young people which focused on the needs of primary and secondary children was fully subscribed. The timing of this course was carefully planned to ensure that teachers would feel able to attend and was run as a 'twilight' course.
In addition the head of pupil support organises training on learning difficulties, the framework for intervention and challenging behaviour, classroom management and dealing with tricky situations for the departmental representatives who are then charged with sharing this within their own department. Training is also undertaken with classroom assistants in dealing with learning difficulties and related problems and this is linked into the work of the integration team. The head of learning support felt that this work had led staff to be more proactive in identifying young people having difficulties and in seeking special arrangements for additional support.
Courses were also run for young people themselves on promoting their own mental health. The 'Mind your Heed' course was well received by young people and had stimulated interest in a range of related topics. Within the drop in service, events and activities were also designed to help young people to develop strategies for promoting their own mental health.
Much of this capacity building work tapped into and linked with other initiatives such as the Sexual Health and Relationships ( SHARE) training supported by Healthy Respect. This course targeted teachers and other professionals with the aim of fostering joint working in the delivery of SHARE to pupils. Similarly the School Council was a mechanism that was heavily promoted by the school to young people and was used by some young people to raise issues such as bullying with staff working with young people.
The Home School Interface
Consultations with parents and young people about proposed programmes and developments were an important element of the approach at Newbattle. The clearest example of this was the preparation for the opening of the drop in service (the Ozone) which provides health advice and information with an emphasis on sexual health. Surveys and meetings were held to explore the key issues and to ensure support for the initiative at a number of points in the development of the service. This approach was adopted for other aspects of the work, for example in the piloting of courses and planned activities. This was welcomed by parents interviewed for the case studies and established a climate in which some parents felt able to participate in the school.
Work with parents also took place at individual and group levels. It included support to initiatives such as an ADHD group for parents. Steps to Excellence courses were run successfully by the health workers and health visitors with 3 groups of parents over 3 years. This motivational goal setting course aims to help participants to identify changes they would like to make in their lives and to devise ways of working towards their goals. Emphasis is placed on confidence building, self esteem and taking control.
The CLICK programme was devised and run by the health worker in collaboration with teachers and school nursing staff and targeted primary school children on a whole class basis. This six week course dealt with issues surrounding loss, change and bereavement and was designed in response to perceptions that this was a significant problem in the area. Consultation with parents and professionals further identified issues for children in relating to step-parents and absentee parents. As a result of this the course focused on change and loss, helping children to deal with anger and to devise coping strategies. Parents were encouraged to attend a final evening session with discussion and practical work on ways of helping children deal with loss. From this a number of referrals for additional support were made which included parents who were trying to deal with their own feelings of loss. The health worker noted that the programme worked best where class teachers themselves engaged with it. In the early stages this initiative was poorly received by teachers but since the pilot it met with more with enthusiasm and plans were being devised to take the course into 10 schools in the area. One head teacher who was interviewed by the research team confirmed that it had been of benefit to staff, parents and children and that it had helped focus further work on related topics.
A parent support group has met weekly since early 2004 under the auspices of the ICS. At the time of the fieldwork, the group was on the verge of becoming an independent voluntary organisation but planned to continue working with the ICS team. All members are single parents who have experienced difficulties with their children in school and some at home. The group was initiated by the family support worker who was already working on an individual basis with parents and who recognised the potential for a group to offer and receive support. The majority of the participants were women and all had experienced stress in dealing with the emotional and social development of their children. Most of their children had been bullied and some were bullies, some had been diagnosed with learning difficulties and some simply found school a difficult environment. Parents were convinced of the value of the support that they had received from the worker and from the group in helping them to negotiate with the school and to persuade school staff of the need for help. In an interview with the research team, a member of the group explained how things had changed for her in dealing with the school about her son who had mild learning difficulties,
..Now I think it is more of a partnership between myself and the integration team because there was a time with my son that I was getting letters, letters, letters and I couldn't cope with this. And was when the integration team stepped in and they said, look this has to stop…the integration team approached me I think..and I must say that (mentions two teachers) have been a good help - they were very understanding.
She made a distinction between what the ICS could do in terms of making the system more flexible for children having difficulties,
…he wouldn't ask for help and it was 'well he sat there for a whole hour and he did no work. And we were saying, but why, there must be a problem here, can you not see that but because they are so busy …that is the difference and that is when their input ( ICS) is so important because they know the system - H knew the system and I don't know the system
She went on to say that she felt the support from herself, the team and teachers had prevented her son getting into serious trouble at school,
They gave him a lot of individual attention - they did sit down and listen to his concerns and they did try a lot of things with him. You know then had him down in the base and changed his timetable about. You know they did a lot to help him individually (Parents group discussion)
While this was a small group, the benefits were highlighted by both parents and staff as helping the participants to deal with stressful situations, develop strategies for approaching school staff and other agencies for support when required, building up ways of relating to their own children, addressing aggression and preventing the escalation of some initially small scale problems into major crises. The value of the weekly meeting was not lost on these parents who recognised the need to build up trust with the worker and with each other.
Multi agency working
This was a major element of the work of the team and there appeared to be a high commitment to drawing different people into this area of work. The team itself was made up of individuals with a range of professional backgrounds and the benefits of this skill mix were well recognised both by the team members and by school staff. The inclusion of the ICS in the Senior Management Group undoubtedly set the tone of partnership working between school and ICS staff. Joint work on the Student Support Group (see section on access to services) between different professionals, parents and sometimes children, created a climate of problem solving for those facing difficulties
At another level, agencies such as Midlothian Young People's Advisory Service ( MYPAS) were active in working with pupils both on the school campus and from their own base in a neighbouring town. The sharing of skills and techniques between different groups of staff was encouraged through team teaching on, for example, the CLICK bereavement programme, SHARE work and joint health programmes. The majority of interviewees were highly positive about this approach but there was some dissent among teaching staff as the following quotation notes in relation to teacher views of the capacity of external agencies and their staff,
think the animosity if that is the right word to use, is more towards the external agents as there is one or two of us that feel, and I would include myself in this based on my experience so far, that they don't really want to be in the school to help - they are volunteering but they are volunteering under duress I think. So there is one or two who are not really competent to be working with a class full of kids even with a teacher in. (Guidance teacher)
Access to Services
A home room system is operated where pupils meet as a group with a homeroom teacher at the start of each day and this group remains together up to S4. A guidance teacher is also allocated to a young person up to S4 and is responsible for teaching for social and health education and for linking with parents.
The Learning Support and Special Needs department has a remit to work with pupils who may be having difficulties in learning or in the classroom. A pupil support base offers mixed provision so children may be referred for behaviour or emotional or psychological reasons. The length of time young people spend in the base is flexible. The ICS links with the base are strong with day to day contact with the manager, social worker and education welfare officer.
The main mechanism for dealing with young people experiencing problems at school was the house meeting which links into the school wide student support group. Children may be referred by their guidance teacher as a result of their own observations or after discussion with home room teachers who may alert them to difficulties with a particular child. A database (Discipline of Learning) enables staff to identify changing patters of behaviour with particular children. The house meeting minutes are circulated to staff in school and occasionally to the staff at the Ozone.
The Student Support Group meets on a fortnightly basis to examine and to decide on action to be taken regarding individual cases. As a result of this a large number of school and integrated community school staff are present as are the educational psychologist, education welfare officer, social worker and representatives of the CAMHs teams and voluntary sector agencies such as MYPAS, all of whom are expected to contribute to the decisions and possible future action. The meeting is chaired by the ICS manager and parents may attend. In some cases members of the ICS team will transport parents to and from the meetings. Protocols have been created for communicating with parents, dealing with confidentiality issues and reviewing progress. Guidance teachers might refer pupils who have been having problems in class or that are experiencing difficulties more generally. If there are problems with a particular subject, young people might be moved out to get special help or an opportunity to reflect on what is going on. Those who may have been out of school for some time will be slowly reintegrated and may spend some time at the support base before rejoining classes.
Guidance wouldn't be part of the discipline process but they would monitor the discipline process and the child's behaviour. They do give detentions for truancy but in the main they are seen very much by the children as their supporters and it is a totally different system and I think it is a good way for it to be as the children can go with their grievances and they feel they will be listened to. So it is quite important for them to be separate but that they do come together and the guidance teacher is involved in that they would monitor somebody's behaviour and say now look you have got all these reports which you never had before what is the problem?
One teacher who had recently joined the school was initially dubious about how the large number of participants could manage this process,
..it is a large group of people and you do wonder how effective it is going to be and it was supposed to be child centred and you wondered just how child centred it was going to be but it is very child centred and this is because the kids themselves are aware that all these people are involved and I think the fact they are in and out of the base so much and they will come in and they will maybe talk to the kids or work with the kids in the base. Today for example some of the IT brought the mum to the meetings and so on. They are part of the whole network and the kids are aware of all that and that is a strength I think of the system ..with the best will in the world, children being children they will try to play people off against each other but I think when they see that everybody is communicating, that everybody has a share and that they are all using that - it is a strength (Interview with behaviour support)
The overall impression given was that the student support group provided a forum where 'people feel that they can speak quite readily and you know, give their opinion and everybody is certainly made to feel very involved' (Social worker). There was a shared view that the synergy of this approach enabled more options to be considered for more complex cases and situations and that this saved time and effort in the long term. Although this was a large group it was unclear how well the approach developed here filtered through to the broader staff group within the school. One teacher noted in an interview that it was unlikely that many would be aware of the work other of the integrated team in general unless they were already involved in some way.
Some difficulties had been experienced in managing the number and weight of cases but this had been resolved to some extent by adding in an alternating meeting of fewer people which dealt with more straightforward cases.
The CAMHS team had recently reviewed their work and one result of this was more locally based workers accessible for advice from professionals and for consultations. This was seen as an important shift that would have positive implications for the work of the team. Support from the CAMHS team had been patchy until this point. Educational psychologists participated in the SSG meetings but their role had changed,
I would say that you do have to plan ahead in terms of using the ed psychs - you can no longer say to them look I need you to come in and see me as obviously they have to buy in their time so you do have to plan ahead in making referrals as well - I wouldn't say it is a problem (Head of pupil support base)
Although parents were encouraged to take part in these meetings, this was clearly at the problematic or remedial end of the spectrum and therefore likely to be a difficult setting for parents to engage. However considerable attention was paid to ensuring parents could attend and in support to them in their efforts to find solutions for their children.
A number of facilities and clubs were supported by the ICS and were viewed as part of the resource for supporting vulnerable young people and their families. A 'breakfast bus' was used to transport young people to a breakfast club at the Ozone drop in centre. The club was open to all pupils and offered breakfast and a chance to start the school day in a welcoming atmosphere. Teaching staff, drop in staff and all workers are charged with identifying young people who may be missing breakfast or who may have little support for getting to school,
If we have kids that we are worried about …that could be about non attendance or social reasons lets say. We actually have a minibus that drives around and will pick kids up and then bring them to school and then get them into the Ozone for breakfast and that is quite a good link as it is again about the integration team being there and if we want to ensure someone comes to school. Because it is another contact we can have with the parents as well (Head of pupil support).
The club sets out to be non stigmatising and to act as a point where young people can seek further help if required and to provide another means of building up relationships with both children and parents. However it is unclear the extent to which this targeting influenced the take up of the services on offer by 'vulnerable' groups.
Activities also took place throughout the year to try to minimise difficulties for young people in the move to secondary school. This transition work included courses, visits, parent sessions and summer activities and particular attention was focused on young people who appeared to be experiencing difficulties in order to ensure that these would not 'slip through the net' and go undetected in the move.
Friendship club
This group met weekly with a support worker and targeted young people who were referred by staff or by parents as the worker explained,
I suppose (it is) for kids that for one reason or another find it hard to make or keep friends. So it fits a lot of kids that are getting bullied in school. There is about 12 in a group and ages from 10-14.
Participants in this group were not specifically selected for interview but one parent of a successful 'graduate' of the group commented that it had been beneficial for her son in helping him build up confidence and skills in dealing with his peers,
I think B was in the first group and it helped him with his social skills - he didn't have any and he played with his sister and with younger kids - he couldn't communicate with his own age group and I would hear him trying to speak to others his own age and he would just go off on one - they just got fed up with him. But now…he is jack the lad.. (Parent group discussion)
A small group run by a guidance teacher was also viewed as beneficial and as an additional support for children who were isolated. The group felt that this guidance teacher went 'the extra mile' to help the children and that the parents appreciated this. Interestingly they described this as exceptional,
I know that his guidance teacher runs a wee lunchtime club just off her own bat and not really much to do with the school - twice a week she takes, I suppose the vulnerable kids, just takes them into her classroom and they play games. I think that makes a big difference for (those two) (Parent group discussion)
A health drop named the Ozone was an initiative supported by Healthy Respect and the ICS. It opens daily and offers a range of health related activities, discussions or just space to eat lunch. Advice and information are available on a range of topics as is the C:Card service for contraception and this mix is viewed as a springboard to working with young people on related emotional and mental health issues. Quizzes and activities are designed to both glean information about young people's worries and interests and to plan further work, some of which is then incorporated into social and health education alongside guidance staff. The drop in is staffed by the school nurse, youth workers and support workers on a rota basis and the team meets after each session to discuss and review the session and to make further plans. Young people and staff were positive about this resource which was sited at a short distance from the main school building and which was viewed as offering separate provision. While it was clear that not all young people used the Ozone, it was well known as a source of advice and support and the staff were deemed to be reliable by those interviewed.
The drop in had experienced a high level of staff turnover. Some interviewees attributed this to the short term nature of the contracts on offer to development workers while others felt that there had been some conflict with the service being sited on school premises. As a result of this, a local youth agency was now managing the centre with staffing from the ICS working alongside the school nurse.
Sustainability
The core posts in the integrated team have been made permanent by the Midlothian Council which represents a major investment in this approach. As a result of this the approach will be rolled out to remaining schools in the area. Considerable skill has been used in securing short term funding to develop aspects of the work and the aim will be to consolidate this through the work of the mainstream posts. In this way the approach has an opportunity to become more embedded across the authority but may face some challenges in working in 'new' territories with staff who may be more sceptical about the benefits of this way of working.
Drop in and preventative work and links with more specialised support were made principally through the work of the student support group which could refer young people to a variety of options. A range of mechanisms were in place to enable young people to seek support on their own behalf or to be referred by key personnel. The provision of the drop in centre in particular offered a means for young people to 'check out' potential sources of help in school through the guidance system or the ICS workers or out of school in community based services such as MYPAS which offered drop in and counselling. The strong links between MYPAS and the school could offer a seamless service.
The ICS offered a synergistic approach that appeared to be well integrated with guidance teams and non-teaching professional workers. However it was less clear about how well this was integrated with general school staff. Nevertheless the existence of this approach over time could provide a conduit for staff and young people to seek support and to view the school as a safe setting in which to do this.
Despite the existence of the parents group and the opportunities for parents to participate in the school support group, clear gaps were evident in the work with parents. The parent group initiative was small scale and involved a particular group who had highly specific needs that were based around their children's difficulties at school. This is not to decry what was clearly a well organised and supported initiative which met complex needs and which actively involved the participants. However there is clearly a need for more parent groups that can engage parents at an earlier stage to support them in dealing with their children and in working with schools. Parents who were interviewed for this study were generally happy with the help given by guidance and by ICS staff but these opportunities to engage with school staff were uneven.
Strengths
- Many of the advantages of an external agency but linked into the school structure and networks
- Capacity to develop embedded relationships between partners over time
- Synergy between different professionals able to work together flexibly
- Potential to influence curricular approaches and effect climate change
- A menu of approaches for young people to seek help
- Base in the community enabled some distance from the school
- Strong team and links into management
Challenges
- Unclear the extent to which the intervention was diffused beyond those already involved
- Small scale nature of work with parents made it difficult to generalise
- Demanded a high level of co-ordination and interaction between the different partners - highly dependent on skills of the integration manager.
Case Study 5: North Glasgow Youth Stress Centre
Introduction
The North Glasgow Youth Stress Centre (hereafter YSC) is a voluntary organisation which works directly with young people in three secondary schools and community settings in North Glasgow. The work is underpinned by a framework of 'emotional literacy' and encompasses group work and individual counselling in schools and community based initiatives. It has been selected as a case study since if offers an example of a voluntary sector based initiative that has developed over seven years and which works on a partnership basis with teachers, pupils and to some extent parents.
North Glasgow includes some of the poorest areas in the UK. Compared to the Scottish averages, substantial areas of disadvantage exist and are characterised by high unemployment, poor educational outcomes and poor material conditions. (Glasgow Springburn Health and Wellbeing Profile quoted in Meager, 2004). Poor mental health is amply demonstrated in statistical data, in assessments undertaken by health professionals in the area and in anecdotal evidence from participants in this case study. Themes such as alcohol and drug misuse, family disruption, poor self image and self esteem, lack of confidence and low expectations were repeatedly highlighted as issues affecting young people and their families in this area. As in other areas psychological services are limited and overstretched. On the positive side, a number of participants pointed to strong community attachments within the area.
The North Glasgow Youth Stress Centre operates under the umbrella of Royston Stress Centre ( RSC) which opened in 1992 and which provides a range of therapeutic stress management services to individuals and groups living in the area. In 1996 the RSC supported the development of a stress centre in the neighbouring Possil area and has been involved in advising on the development of services in a range of settings. The aims of the RSC are to empower local people to manage stress more effectively, lessen reliance on 'illness services' and enable residents to develop to their full potential and improve their quality of life (Meager, 2004).
The RSC set up the North Glasgow Youth Stress Centre ( YSC) in 2000 in recognition of the unmet and growing needs of young people and in response to requests from schools for support for pupils in dealing with stress. The YSC is currently based in an industrial unit which is connected to, but separate from the adult stress centre on an industrial estate which lies at the intersection between a number of different neighbourhoods. It is thus accessible to a range of people but sited on relatively 'neutral' territory. Nevertheless some young people who were interviewed stated that young men living in some surrounding areas would be reluctant to attend the centre as they felt that it was sited on hostile territory where they might be attacked. Although the centre in this case study acts primarily as an office base and is rarely used by young people, such comments highlight a recurring theme among young people in the overall study about where help would be sought within localities.
As with many voluntary sector initiatives, funding is drawn from a patchwork of sources including the Greater Glasgow Child and Mental Health Fund ( GGMHF), North Glasgow Social Inclusion Partnership ( SIP), Glasgow Local Health Care Co-operative ( LHCC) and Glasgow Council Social Work Services. Each of these funding bodies supports one or more aspects of the work with the core work focusing on emotional literacy work with pilots of new approaches or work with emerging groups being undertaken of necessity, on a time limited basis. Thus the emphasis of GGMHF and SIP is on direct services with young people, a focus which limits the potential of the centre to undertake capacity building activities. Core funding remains elusive and the future of the centre is as precarious as when it opened. Despite this the project claims to be 'the first of its kind in Scotland to develop emotional literacy programmes in schools' and it has sustained programmes based on this model in schools and community settings over five years (Meager, 2004).
This case study focuses on the work in two local secondary schools: the first is a new purpose built school which has accorded a high profile to pastoral care and which has integrated key aspects of the work of the YSC into their programmes. The second school is based an older building, and includes a high number of asylum seeker children. The first school is non denominational while the second is denominational and includes children from beyond the immediate area. The ways in which the work has developed in these two schools serves to illustrate the flexibility of the approach taken by the YSC and highlights some key questions about the approach.
The approach
The YSC sets out to work in partnership with schools to deliver services directly to young people and the mission statement outlines the overarching aims:
to provide opportunities for them to develop increased awareness of stress and the probable causes and effects; acquire and improve personal, emotional and vocational skills, improve health and well being, develop strategies to deal with and reduce stress and enhance the potential of young people for the future (Interim report for GGHB, 2004).
The centre aims to work with the general youth population in equipping them with skills and strategies that can assist them to deal with relationships and difficulties that they may face as they grow up. In addition they take a targeted approach to working on specific issues with small groups and in one to one counselling work.
The mechanisms include:
- small group work on a range of topics such as assertiveness, anger/conflict resolution, assertiveness, peer support, exam stress, bereavement,
- 15 week courses on emotional literacy for 11-18 year olds
- one to one counselling.
- basic and advanced training courses for professionals on a multidisciplinary basis.
All staff and volunteers have undertaken training on emotional literacy. The team includes trained counsellors, community workers and a half time manager who oversees the work of the centre, negotiates with funding agencies and collaborates with schools and stakeholder groups.
In the early years of the centre, strategic work had a high profile as the centre strove to develop links with schools and to work with staff to formulate the plans for courses and develop protocols for counselling work. More recently the demands of funding bodies and schools for service delivery has curtailed participation at broader planning and policy levels. In practice the majority of referrals for counselling are made by schools but the centre also takes referrals from parents, young people and other agencies. Specific decisions have been taken not to advertise these services. Similarly although extension of the service to primary schools is seen as desirable no work is currently undertaken due to a lack of resources.
Mental health and wellbeing and behaviour in schools
In this section we explore the work of the YSC in two schools. It was clear that the work had taken a different line in these settings and this perhaps reflects their different preoccupations and priorities. At the same time it illustrates the flexibility of the approach of YSC in being able to tailor the work to the identified needs.
In the first school the work was initiated after a teacher sought out the services of the Royston Stress Centre as part of a quest for specific services for one pupil. In doing this the teacher became aware of wider needs that were not being met by the school. The Royston Stress Centre set up the YSC in 2000 to develop and run emotional literacy courses with the school. These courses have continued over five years on a partnership basis and are now integrated into the personal and social education curriculum. Classes are divided into groups of 10 or 12 and undertake the emotional literacy 15 week course in S1, S2 and S3. In addition to this 2 counsellors ran one to one counselling sessions with referred pupils over 2 days a week in the school. This school encourages the input of a range of external agencies to the school in general. For example, a health development officer is based in the school for half the week, Barnardo's works with vulnerable pupils in transition groups and students from psychology and teacher training courses are encouraged to work with children in the learning support base. Glasgow University has jointly produced a video of the work of the pastoral care team in the school and with the YSC for training of teachers and students. The work of the YSC is viewed as central to the focus on emotional and mental wellbeing and to some extent behaviour management. Within this school it was clear that mental wellbeing was accorded a high priority with a strong pastoral care team. An extensive consultation with teachers, pupils, parents and external agencies had been carried out over several months over a proposed statement of values for the school. The final statement specifically highlighted the importance of mental wellbeing to the success of the school. In addition the health development worker for the area had mental health as a key priority for her work with schools in the cluster.
The second school had a relatively high number of asylum seeker children in the school and were well aware of the pressures that these children were under both at home and in school. As a result of this, an official with a remit to liase with asylum seeker children was based in the school and worked with families, teachers and young people themselves. The YSC also had secured funding for a dedicated worker for asylum seeker children who undertook individual counselling and group work within the school in partnership with the pastoral care team. Mental health and wellbeing was again accorded a high priority in this school but the group work took a different form. Here guidance staff selected the participants for the twelve or fifteen week courses and these young people were then withdrawn from their class to take part in the group work. A mix of young people with behavioural difficulties and asylum seeker children were chosen with the overall aim of integrating both into the mainstream. This different model posed some challenges for the workers in reconciling the different needs of the individual young people. However it was clear from reports by participants that the group sessions were welcomed, provided a supportive environment and had benefits for young people in helping them to deal with their everyday experiences in school.
A major difficulty arose in trying to break down barriers between the two different groups. In one session where the researcher observed the group, an initial and marked polarisation between the asylum seeker children and the others gradually broke down over the course of the session. However this took time within a very tight timetable of one lesson. In conversation with the workers it appeared that they had little control over the selection of children although they could and had made changes in groups where they felt this was necessary. The workers had designed specific techniques to encourage the participants to share and work with each other and worked hard to create a comfortable climate. The participants were highly positive about the value of the group in conversation with the researcher although one young person speculated whether she had been recruited because she was badly behaved.
In this respect the partnership approach seemed to operate strongly on the school's terms. A member of school staff defended this approach suggesting that it fostered a valuable mixing between groups that was difficult to achieve in other elements of the school programme and that this could have positive value in the long term acceptance of difference between young people in the school. It also provided a means of helping young people to access more help if this was required and to identify personnel within the school who could offer support.
Within the school, the value of the approach for all young people was also noted and one teacher felt that every pupil could benefit from the work of the YSC. An example was given of another strand of work which had taken place with a group of senior girls who did not pose behavioural problems but who had benefited from the input of the YSC,
Our girls you know 5th and 6th year girls you know there is no difficult behaviour there but they lack that self esteem that lack of confidence, …they don't have that confidence that kids have if you like in ..the leafy suburbs you know ….but the girls loved it , you know these were not girls with any behaviour problems at all but it was just you know the whole drama bit again of acting out and being, having someone and the counsellor who was accepting them for what they were and nothing was going outside the room you know, they set down the parameters and they did respect one another unfortunately they haven't got the staff (Guidance).
The school staff recognised this was not a one off need and hoped to replicate the work in future years should funding be available to the YSC.
It was clear that in both schools the pastoral care teachers were the best informed about the links between mental health and school behaviour and were likely to be in regular contact with the YSC over their work in schools. Teachers placed great value on the externally based work as filling gaps that could not be met by in-school provision. The flexible approach adopted by the YSC at managerial and fieldwork levels was highly valued and the specialist expertise was seen as an important addition to the support services within the school. Staff in both schools mentioned the ease with which they could contact the centre and discuss issues or concerns. Regular reviews took place between school staff and YSC workers about the progress. YSC staff based this on evaluations completed for sessions and on issues arising on either future development or needs for more specialised support. This included exploration of potential areas of concern that could be addressed more generally within classroom sessions by school staff themselves. These included generic health topics, more problematic issues such as violence, drug taking and alcohol and mental health. In this way both groups of staff could be alerted to emerging issues and any needs for specialised work.
The YSC staff viewed mainstream teachers as less likely to make these links and suggested a number of underlying issues,
I think the pastoral care teachers will look behind that (behaviour) as that is part of their job but I don't think all the teachers you know are interested in that you know and I think for a lot of the teachers the focus is academic achievement and if the young person is not interested then you know… the young person becomes rubbished rather than looking at it from a different place and again I know that it's not the teachers problem, that's the culture we live in. ( YSC worker)
It was clear that that many teachers were highly pressurised themselves and that schools were sometimes places characterised by anxiety for staff as much as for pupils. Some teachers pointed to the particular issues facing schools in deprived communities,
I see the mental health of the children not at all fully addressed, I'm totally aware of it all the time, even just the fact they are doing 7 or 8 standard grades - I went into {a} class yesterday and yes, there it was, the atmosphere was terrible because here was the teacher trying to get the folios up to date right and the wire is next week or something, now that's been going on for months, it's not the teachers' fault, it's not the kids fault, it's just the way we are, we are an inner city school we have 80% unemployment and all the rest of it…kids are under tremendous pressure..and that runs from 3rd year up and they're not getting you know, the parental support and understanding of the pressure they are under (Guidance)
For some the emphasis on attainment and the business ethos reinforced this and could blind teachers to the difficulties some children were encountering,
It's the management structure of business which has been transported in here and put onto teachers - I'm not saying that they forget the kids are kids but we're not making cars and we're not producing new dresses for Marks and Spencers or anything, we're dealing with children and that causes pressure on the staff, they're trying to cope with their own mental pressure do you know what I mean? (Guidance)
The work of the YSC aimed to address this by taking a holistic approach at both universal and targeted levels. This entailed taking account of the needs of less obvious groups including more withdrawn children and supporting them to make themselves heard and to participate but this relied on teaching staff to identify young people and to call in the YSC staff,
I think it tends to be the noisy ones that get picked up on (by teachers generally) but that's part of the reason behind our emotional literacy programme, that it's active and its noisy because that's part of what we try and do, is we want to ensure that the quieter ones have a voice as well… we usually work with groups of between 10 and 15 and you know everyone gets to say something and where there are quieter ones we can support them and bring them out which within a normal classroom doesn't tend to happen… ( YSC worker)
In some cases however, very disruptive children would be asked to leave the group if the group workers felt that they could not deal with their needs and the group as a whole. In such cases, efforts would be made to ensure that some input was on offer with some cases referred for individual counselling, some for anger management or specialist support. School staff were impressed with the scope of this work,
The group work I think has been really, really good because it's given the kids an opportunity to talk, totally confidentially to a non teacher in a controlled situation so they've been able to speak about a wide variety of issues; anger management, coping with school, coping with their own wee lives and for many of these children the issues will be of a completely wide variety and …they'll be doing group activities, so it is like a drama based thing so the kids are able to act it out..(Guidance)
It was clear that work on bereavement, self harm, alcohol and drug misuse dealing with conflict and anger was viewed by schools as appropriate issues for the YSC work to focus on. However the staff at YSC viewed schools generally as more reluctant to engage with some mental health issues and this related to the ethos of the school,
In terms of maybe sexuality issues, disability or young people that are maybe getting bullied and stuff, I don't think that is picked up on to the same extent or it's ignored because the school doesn't really want to open up that discussion you know ( YSC worker).
The centre staff also believed that they would be more effective if they could extend their emotional literacy work to primary schools,
We see going in and working with even the first years, if we could get in while they were in primary school, I think it would make a major difference as there are identified issues for some before they move to secondary. And primaries are a captive audience as they tend to have more circle time and things like that ( YSC worker).
Overall schools appeared to identify links and to seek the help of this external agency in dealing with these. However this understanding was partial and uneven with the North Glasgow Youth Stress Centre limited in its capacity to tackle this since their contact with teachers outside the pastoral care sections.
Capacity Building
I think there is some work that we do that can't be done by teachers but I think there's also room for teachers to improve their emotional literacy in terms of how they relate to young people ( YSC worker)
Capacity building on emotional literacy was a central theme for YSC in their work with both professionals and young people. Using this framework they set out to help their clientele to recognise the issues facing them and to use this as a basis for devising strategies for dealing with these. YSC staff maintained that they could offer something that teachers were less confident to tackle for a number of reasons. In order to do this, there had to be a shared acceptance of their approach as supplementing the personal and social education courses in school. Enhancing the capacity of teachers was viewed as critical for the success of the work with children but this was uneven as the principal focus was currently direct service provision to young people. A health professional noted that teachers were often unable to identify this aspect of their role,
Perhaps if they stood back and looked. But they are so fraught with the amount of stuff they have to do and all they see is bad behaviour and they don't or can't look at the underlying reasons (health professional)
The need for teachers to develop their own capacity in relation to work on these topics was well recognised within the schools that participated in the case study. The centre had previously attempted to extend their own training on emotional literacy to teachers and other professionals working with young people. However take up by teachers was limited due to difficulties in organising cover for daytime courses. One course took place in an evening but this attracted other professionals but no teachers. In one case the YSC had subsidised a key teacher in one school to participate in a training course. Subsequently this teacher acted as a link and facilitated their entry into a previously reluctant school. In service training for staff in one school featured emotional literacy and this had been beneficial in raising the profile of the work of the YSC beyond those already familiar with their work. The difficulties in recruiting teachers for interdisciplinary training is raised elsewhere in this report. A pragmatic approach was adopted by one teacher in promoting the work of the YSC and in meeting the needs of teachers as partners in this process,
I think when you try to introduce anything new into the school the big issue is to try and raise awareness with all staff and the benefits for all staff because really we have to seek staff approval for what we are doing - that is the only way we can get projects off the ground. When we are looking at counselling and the other activities, we are looking to staff to release pupils and saying to them that in the long run this was going to have positive manifestations for their class room. So what we did from a very early stage was to use in service days for information, awareness sessions and also invited all members of staff to become involved in the type of sessions that the young people would be involved in with the ysc. So many of our staff have experienced the deep breathing exercises, the relaxation exercises, in order that the work of our partner was valued and recognised by teachers in the school but also it was important to them - when the pupils came back they were sometimes floating along (laughs) you could see a transformation in them - so they could control their emotions in the class - if they get angry - if teachers can see that there is something in it for them then that is where you are going to have a true type of support.
In relation to work with young people, both school staff and parents were convinced of the value of the capacity building approach,
I think the youngsters have benefited from both the group work and the individual counselling as they have been able to learn techniques and so on that they can adapt and use for themselves (Guidance)
Capacity building with other professionals took place mainly in courses or commissioned work which was an income generating feature of the YSC approach. Work with parents focused on building up their skills and confidence in dealing with issues that faced them in dealing with their own problems and those of their children and is covered in the next section on stakeholders.
Stakeholders
In this section we explore the views of YSC staff, pupils and parents as stakeholders in relation to the work of the YSC in schools. There was widespread recognition that parenting was particularly difficult in such inner city areas where money was in short supply. Some professionals concluded that many parents had themselves been poorly parented and simply lacked the skills to undertake this with their own children. As a result some workers felt that they were cast in the role of parents,
Sometimes we become the role models and parents as there is no-one there for them ( YSC worker)
YSC work with parents focused on those who had identified problems of their own which affected their capacity to parent their children and those who were struggling to deal with children who had behavioural problems at school and possibly mental health issues. In some cases parents self referred while others were referred to the YSC by school staff or health services. As with other aspects of the work this service was not advertised due to a fear that demand would outstrip capacity since the centre was already stretched. One to one work with adults was undertaken by the Stress Centre and this included stress management, a range of relaxation techniques, massage and counselling. A parents support group met at the YSC with the support of group workers over a number of months. Members of this group were parents of children at each of the schools in the area. Interviews with parents took place with individuals and with a group.
One parent had received lengthy counselling and relaxation on her own behalf. She first sought help on her own behalf as she felt unable to focus on the emotional wellbeing of her children since she was so immersed in her own problems. She described herself as being on 'automatic pilot'. Later she joined the parents group and believed this had been of great benefit in helping her to recognise how her own problems influenced her relationships with her children. She felt that before this she had tried, unsuccessfully, to suppress her feelings of despair and that joining the group and having counselling helped her to address these and devise ways of tackling them. The parent group was a place where she could be open about this and where she could learn from the experience of other parents. She has used the emotional literacy techniques learned at the centre with her children and with friends and felt that this had helped considerably in identifying underlying issues. Overall she felt that teachers and the school had also tried to be supportive and had responded to her anxieties in a positive light.
Another parent was less positive about the schools capacity to offer a safe haven for young people and reflected on her own experience,
..for me as a kid I mean …I truly had some bad experiences with teachers…making me feel so low that I couldn't speak out with the answers and just totally going into a mind block you know that way - I'd be that uptight when the teachers..in case I got it wrong… that I froze and my mind just went totally blank, so she'd throw chalk at my head and all that kind of stuff you know..I think for me not wanting to go to school, I used to cry, I used to make myself sick, begging my mum to let (me stay at home),.. its all through teachers, I never had any problems with any of my peers… (Parent 2).
Young people who were interviewed for this study felt that school was not a place where they would seek help for personal problems although they believed that some teachers would be supportive. Some felt that teachers might make things worse by drawing attention to the young person, others felt that many problems were simply too difficult to deal with. The majority thought that it was good to have people coming into the school from outside as they often had more experience and could relate to young people in a different way to teachers. Those who knew of the work of the YSC were very positive about it and felt that the group work had been fun and useful but they would be unlikely to visit the centre itself as it was sited in alien territory. Some of those interviewed felt that bad behaviour was not usually linked to emotional issues and should be treated firmly in school but some also felt that some teachers were very unfair in their treatment of some young people. Family members such as aunts, older sisters and grannies were identified as more likely sources of support or at least as people who would take any issues seriously but friends were the most likely confidantes. However PSE that focused on emotional and mental health issues was given a favourable mention and was contrasted with religious education which was dismissed as 'a waste of time'.
Funding bodies were also stakeholders and were referred to by staff as determining much of the direction that the YSC could take. This was particularly the case in relation to extending the work into new areas which inevitably led the manager to devote time to preparing bids, writing up reports for funding bodies and negotiating over contracts as part of her part time remit. This raises key questions about the long term sustainability of the initiative.
Sustainability
An external agency with a portfolio of approaches held great appeal for the staff interviewed in the schools. Some schools had been very sceptical of the approach and considerable effort had gone into establishing credibility with school staff. As a community based resource able to make strong links with parents, schools and young people the YSC was well placed to work at both preventative and remedial levels. The provision of specialist counselling within a social rather than a medical model of health also removed some of the stigma associated in seeking help for stress and mental health issues. The work of the YSC was clearly embedded in schools in the area with more demand for work than could be accommodated and it drew glowing testimonials from a range of professionals across and beyond the immediate target groups. However the capacity of such a small voluntary organisation is clearly limited and in this section we consider some of the long term implications of this approach.
Most referrals to the YSC were made by schools but there is extensive linking with GPs health visitors and educational psychology. Some referrals have also been taken from parents and children themselves who often hear of the initiative through word of mouth. However the decision was taken to limit information to other agencies due to fears that the potential volume of demand could not be met,
We don't do publicity for the very reason that it's just impossible to keep on top of it and you don't want to be raising expectations and saying oh look here, we are here and then you say, well we'll maybe see you in six months time ( YSC worker).
Fears about the long term viability of the approach were voiced by staff in both schools. In one school, the underpinning framework continued to be important but additional support was being sought elsewhere in order to sustain the impetus,
What concerns me a little bit is that of late you know what YSC have been able to give us has been lessened ..I think it's almost part and parcel of what the pse ..arrangements are and really what concerns me is that that it's really been because the school and YSC have joined up and made big efforts to join up otherwise we wouldn't have this resource at all and the negative implication is if these things, this good practice, is withdrawn …(Guidance)
Capacity to engage in policy making and practice is also limited. As with any small organisation, maternity leave and long term sickness can have a disproportionate impact on the viability of the agency. While the service appears to be offering much needed support and a flexible and creative approach which is valued by partners and users, this is based on a very tight time limited budget and an equally small if dedicated workforce. The lessons to be learned from the experience of this approach have been well written up and appear to be well regarded but will be limited if capacity to plan ahead continues to be constrained by such limited resource.
Effectiveness
In all schools guidance staff were unanimous about the benefits of the approach taken by YSC and cited examples of children who had benefited from the intervention as seeming happier, more confident, and as demonstrating higher self esteem. Evidence however tended to be anecdotal and referred to individual children. The YSC compiled extensive evaluations of the work for their own benefit but in common with much work in this field, 'hard' data was more elusive. Some class teachers had pointed out to the PT guidance that the behaviour of one boy in particular had improved drastically while he attended the group but 'when it stopped, when another group was taken on, this boy actually went back to what he was like so maybe it wasn't long enough, maybe he needed more time'.
There was no suggestion that returning to the same situation had perhaps itself made it difficult for the child to sustain his 'good' behaviour.
And we have a pupil who has had similar dreadful things happen and {the success of this individual} is directly attributable to the partnership between the stress centre and (the school). They have given her such confidence in herself that she can use the techniques that {the worker} used with her and other children in 1st and 2nd year that are going through similar circumstances that she had to deal with (Guidance).
Staff in schools suggested that the impact across the school was less evident since knowledge of the intervention was confined to participants in the group or individual work and their friends. On the other hand staff overall were made aware through bulletins, newsletters and word of mouth sharing of information. However for those who had participated in the courses, clear gains were noted by teaching and learning support staff in all schools,
I think 5 years up the line there is very strong evidence to suggest that pupils who have had that input from these trained workers have developed emotionally better than those that haven't had the input (Guidance)
I suppose the hard evidence is that pupils that we would have had major concerns about in the school in relation to an attendance issue or a behavioural issue have survived and even done well in some cases. I mean that would give you the hard indicators. We can say that in certain instances attendance has improved dramatically and behaviour has improved as well. We could point that out (Teacher).
Multi Agency working
As an external agency, the YSC believes that they can complement the role of teaching staff, reach out to young people who might be reluctant to engage with teachers on emotional issues, offer an approach which engages young people as active participants and work with parents of young people who are having difficulties in school. The YSC is dependent on schools inviting them to work with them. This was initially relatively straightforward with one school but less so with others in the area. However as the work has developed, collaborating schools have requested additional work from the centre and additional schools have asked for input. It is clear that credibility has therefore been built up across the area among school staff and this provides the YSC with an important backdrop for future partnership work.
The development of the relationship between the YSC and one school illustrates some key factors for stakeholders. The partnership came about as a result of one teacher attempting to seek specialist help for a pupil. This had finally led to the RSC and discussions with the manager about the need for more sustained activity on mental and emotional wellbeing. One teacher reflected that without the individual counseling input from YSC, a number of pupils 'would be into serious drug abuse, non attendance, depression'. For this and other teachers, the success of this work was based on the joint development of clear protocols and shared agreements about the planning, delivery and evaluation of the work between the school and the YSC. This process had built up trust between the centre and the school and fostered a shared vision of the work with the partners able to anticipate potential problems that could arise and that the work had a number of advantages, not least in alerting school staff to underlying issues. While this could be interpreted as a form of more sophisticated surveillance of pupils, it clearly provided a way for pse work to be tailored to the needs of the pupils at that time,
The huge benefit of having an external agency like that is that they are often a conduit to pupil behaviour and pupil attitude. Now often people are a bit more reticent about you know, about what is happening in their street, what is happening in their peer culture, whereas in a group where you have a person who is held in respect but who is not a teacher, information often flows more easily. There is a more relaxed atmosphere you know, more time is spent on young people on what they do outside the school as opposed to what they do inside the school and often issues will come up about a group within the school - could be underage drinking, or underage sex or drug abuse or domestic abuse. Often those issues will come to us via the external agency and that is where I think they are so valuable as they will come along and say, look …a lot of the 3rd years are talking about whatever and what we can then do is look at our pse programme which is flexible and bring into the programme issues that young people have been raising. So in a way you are kind of proactively being reactive - you are feeding each other information which gives the young people more support in their life (Guidance).
The work is based on a partnership approach which was highly valued by this teacher,
we respect the value of what that team brings - it is not a crisis, help or a knee jerk reaction, it is a planned programme and it is one of a range - not just the counselling or the input to pse but we also have small group work particularly for single sex groups on emotional literacy and intelligence(Guidance).
But working with the schools had not been plain sailing and the YSC staff had to work at building up relationships with other schools in the area and involved the continual build up of links with staff in schools, presenting the work undertaken by the centre to a range of groups and individuals, organising training courses and making these as accessible as possible for schools and other professionals in the area. As a result of this networking and groundwork, key contacts were established within all schools in the area. This was described as having 'opened the door' in allowing the project to take its work to new groups of staff and young people.
Within schools, pastoral care teachers were viewed as having a clearer perspective than many of their colleagues on the needs of young people, on the ways in which these should be tackled and on the value of external agencies,
They're the ones that tend to be open to being involved or are the ones who are really supportive and want you in to do the work because you know they've got that part of their role within the school and they know how difficult it is to work with young people on that emotional level, so they're keen to get as much support as they can (Guidance).
Workers and some school staff felt that some teachers were uncomfortable with the YSC presence in schools and while there was some acceptance that this was inevitable, efforts were made to engage with these staff in the hope that they would see the advantages of the approach. Sessions in schools and training events were offered in an attempt to address this.
Some teachers were still reluctant to allow YSC staff to work with groups without a teacher being present. This was turned around to allow the opportunity to team teach on occasion but at other times it was seen as a trade off,
Some of the staff have worked with teachers who..have maybe not been involved in delivering the program but they've actually sat in as some of the schools feel that they need to have a teacher involved for you know just ensuring discipline or stuff like that and they don't take an active part in the program… ( YSC worker)
There was a general feeling however among the YSC staff that inroads had been made and that more teachers valued their work,
We've been here four years you know and at first the assistant heads that we met with maybe weren't that open but now they are constantly saying to us, I mean all the time, we want you in here more. ( YSC worker)
Teachers themselves referred to their own anxieties about work in this area and about resistance to outsiders who were not teachers by training. This teacher is commenting on inter agency training,
well teachers are a breed to themselves I think, without knocking my colleagues and myself, it's difficult when you mix with non teachers because you know you've got different parameters and then in the other sense I suppose it's good because you see where they are coming from (Guidance)
Although the partnership approach was viewed positively by school staff, this seemed to be based on YSC successfully passing some 'testing out' by making it clear to school staff that group work could not be focused simply on the most difficult young people.
We had one group last year and when we put the group together and I saw the names, I thought, oh, dear God, you know that would send anyone to the moon you know. They ( YSC staff) came back to say, that won't work you know, so that was the good thing, they did, they're realistic in the sense of what they can't achieve because I thought if they can turn that group around that's absolute magic but no, they didn't because that groups was far too challenging..you know the kids were off the wall and real social background, behavioural problems….(Guidance)
The speaker was clearly impressed by the decision taken by YSC staff and viewed the potential group as impossible to manage in that format. Importantly the individuals concerned were offered alternative provision through joint discussion between YSC and school staff, thus reinforcing the partnership approach.
Some YSC staff felt that this was an age related issue and this was a recurring comment in the overall study by both teachers and other staff. This may be a reflection on changes in the wider context of the profession with demands for more inclusive practice which bring along with them requirements for more reflexive approaches,
I think the teachers you know see it (the school) as their kind of domain and they can be quite suspicious of people coming in. I think that is changing though and sometimes it is I would say, the old school teachers who have maybe been there for a long time…I think the whole area of emotions you know, because you don't go there, that's not something that is to do with the school - that is something you do outside school and family so there is a fear of it I would say ( YSC worker).
In one school, the centre worked alongside a pupil support unit on individual and group work basis on conflict resolution, anger management and school refusing. Not all the children in the base were referred because of their behaviour but sometimes bereavement or illness and the input was designed to reflect this diversity. Staff at the unit valued this specialist input highly and stressed that it added a dimension to the work that was not available to them as teachers.
Some underlying issues were difficult to resolve. For example in working with denominational schools, issues around sexuality or pregnancy were problematic even if parental permission had been given and this constraint could undermine the holistic approach taken by centre staff. Dealing with children whose families were in turmoil or living with uncertainty were major issues for all partners and could require a much greater degree of specialist support than could be provided. These issues have much wider resonance in dealing with mental health matters in schools generally.
At another level, ensuring communication flow can be highly problematic. In some cases, when children were suspended from school, on occasions, the schools permitted the child to attend school for their one to one counselling session. However at times communication between schools and the YSC was poor so that YSC counsellors were sometimes not informed in time to make other arrangements.
Balancing child protection and confidentiality issues can throw up a range of dilemmas. Confidentiality was referred to as an issue for the YSC - tensions over how to preserve the privacy of the young person but also to alert key staff that something was wrong was a key area of difficulty,
A teacher may have information about a young person but it's about how many teachers do you let know about that without breaking the confidence of the young person - I was working with a young woman …and there were lots of issues there, but it wasn't appropriate to tell some of the teachers about that but yet she was kicking off in class and they didn't understand why and in some ways maybe if they had understood it might have made a difference ( YSC worker).
The issue of disclosing information about particular cases continued to raise ethical questions that cannot be answered glibly. While project staff were very clear about their guidelines and were rigorous in adhering to these, it was evident that they could also see the wider picture and identify instances where other professionals could have benefited from more understanding of the background to particular cases. Thus the constraints of confidentiality were well recognised. This is a difficult issue in interdisciplinary working, in reconciling the different protocols and underlying frameworks in use. That staff from diverse backgrounds who participated in this study consistently paid tribute to the professionalism of the YSC staff in this regard demonstrates the extent to which the overarching principles of their work had become accepted by partners and other stakeholders. This does not remove the problem but perhaps contributes to a climate in which such thorny issues can be more constructively discussed and explored.
Summary
Strengths
- Advantages of external agency in being able to engage children on an informal basis
- Flexibility of the approach - able to work on a range of levels
- Ability to engage professionals in joint approach to the work
- Community base enabling contact with parents on more than a fleeting basis
- Careful initial planning offsets some of the difficulties of being a small organisation
- Persistence over time in building up networks and grounding the work within the school
Challenges
- Capacity to expand limited by underfunding, part time nature of contracts etc and tied to specific and often 'pilots' rather than longer term initiatives
- Limited capacity to build on experience and extend into new areas such as primary school work
- Limited capacity undermined involvement at strategic levels on a continuous basis
References
Meager M (2004) North Glasgow Youth Stress Centre Interim Report for Greater Glasgow Health Board. Glasgow: North Glasgow Youth Stress Centre
Case Study 6: Clydebank High School, Support Services Team.
Clydebank High School, in West Dunbartonshire is located in an area where an estimated one in three families are experiencing deprivation. The school was selected as a case study due to the innovative responses that had been developed to supporting pupils and their families. The approaches taken in the school were underpinned by a commitment to the emotional well being of pupils, and an understanding of the relationship between the welfare of the family and the wellbeing of the children and the associated impact of structural issues such as poverty.
This school is distinct from others in the case study sample in that the support team were all employed and managed by the school, so the ownership and control of the model lay with the head teacher and one of the deputes, who was a very committed champion of the initiative. Organisational changes had been implemented to develop the capacity of existing key staff to identify and respond to difficulties experienced by pupils, and this was enhanced by a team of pupil and family support workers.
The support services team had been created by linking together a team of teaching and non teaching staff, all of whom were devoted to the welfare of pupils, but in different and previously disjointed ways. Firstly, a commitment had been made to forge closer links between exiting teaching staff who had complementary roles in supporting pupils, namely pastoral care staff (formerly guidance), behaviour support and support for learning, who now shared a large office and were building a system of common record keeping. Secondly, the school employed four pupil and family support workers, funded through Better Neighbourhood Services whose remit was to offer support to vulnerable pupils in school, and to develop links with families experiencing difficulties. Targeted groups included pupils experiencing mental health difficulties, as well as vulnerable groups such as looked after children, those with a disability, families living in poverty, or affected by addiction, and black and ethnic minority pupils.
Additionally a careers officer and an attendance officer were associated with the team. The school's commitment to the well being of the pupils within the wider context of the family was also evident in the links that were being developed at the time with West Dunbartonshire Domestic Abuse Partnership, through a worker being based in the school for a year to develop and deliver curriculum resources for the schools in the area. (Whether the domestic abuse worker was considered to be a member of the support services team appeared to be matter of debate).
Traditionally, pastoral care staff, behaviour support and support for learning have been seen as separate departments within schools, and remain as such in most Scottish secondary schools at the moment. To join these groups together as one team, with shared responsibilities and record keeping was a considerable change for the staff involved. The staff identified these changes as advantageous for themselves and the pupils in a number of ways. They felt they had developed a better understanding of the roles of other key people in support of the pupils, could see their own role as part of a larger effort and were able to take a more rounded view of children. Communication between them was more immediate, and there was more scope for informal discussion:
I think it's been fine from the pastoral care point of view because there was always a situation of duplication. There wasn't a centralised filing system, just the fact that we are all in the same base room allows that to happen. But we are also able to talk about children without having to run around the school….there is a lot of informal discussion about pupils that has positive vibes to it, but it would never have taken place before (Pastoral care teacher)
They felt the young people benefited from a more sophisticated system of detection and reporting, and they felt that the closer working ties between themselves reduced the likelihood of vulnerable pupils slipping unnoticed through holes in the system.
Systems were also developed in the wider school to support the team in their task of identifying pupils experiencing difficulties. Extended morning and afternoon registration allowed a little extra time for them to make contact with pupils. And a sensitive dual system of reporting problems operated in the school, whereby teachers' concerns could be communicated through either a disciplinary or a welfare route (or both), but the two systems were cross referenced by the senior management. Hence a disciplinary matter would often trigger a "guidance alert", allowing pastoral care staff to investigate any underlying causes of the behaviour. The support services team felt that withdrawn behaviour was also identified and reported by the wider staff, especially PE staff and classroom auxiliaries who, they felt, were in a position to see children in a different way.
The other arm of the support services team was the group of four pupil and family support workers, who had been in place since 2002. Their work was funded by Better Neighbourhood Services, a funding source targeted at issues of social welfare and social inclusion. The team were all women, who lived reasonably locally, and, being neither teachers or social workers, were presented as a non-threatening support to families in the area. Work with families was very much a response to need and could take a variety of forms, but was essentially a sympathetic, pragmatic and practical support, offering a listening ear, discussing difficult issues, liasing with other services, accompanying parents to appointments and encouraging and supporting parents through difficulties. The team would also collect pupils from home, where this was helpful. From this work, the workers were able to communicate to the school some of the difficulties the children of the family were likely to face, enabling appropriate supports to be available in school. This service was also provided to five associated primary schools.
Within school the pupils and family support team were based in "room 43", which provided time-out for pupils experiencing difficulties in the school setting. Access to the room was controlled by senior management and pastoral care staff, so it was not available as a "sin bin" for the wider teaching staff, rather it was seen as a refuge for pupils who had been identified as experiencing difficulties. Pupils who were in the room during lesson times were those who were not coping in the wider school environment, and the room was seen as a safe haven. Once a young person had been identified as a user of room 43 they could in some cases, depending on their personal circumstances be given the option of choosing to go to the room at any time. Possession of a "room 43 card" indicated to teachers that the pupil could leave classes. A key theme identified by the staff in the school was that of being able to allow the various actors in the school setting to handle difficult situations with dignity:
It [the support services team] allows dignity for pupils, and the member of staff is allowed to continue to do the learning and teaching, and the member of staff has not lost face either (Depute head teacher).
Pupils who used the room regularly during the school day used the time to work towards individual targets, which had been negotiated between the pupil, the support worker and other members of the team.
Room 43 also provided a lunchtime and break time base for some pupils who had difficulties coping with the unstructured environment. At these times of day a sizeable group of pupils could be seen in the room, which offered an alternative social setting for these young people. This facility was available only to pupils already associated with the pupil and family support team, and for most it was an optional "drop-in" arrangement. For a small number of young people, with particular problems ( e.g. drug habits, or tendency to truancy) attendance in room 43 was compulsory at breaktimes, and some pupils were escorted by the pupils and family support staff to and from lessons for similar reasons.
Team working
The development of this team necessitated new forms of working relationships between those in different positions within the school, who brought different understandings to the work. For the teaching members of the team, the new working practices appeared to be largely embedded by the time of the case study, with those interviewed acknowledging the benefits of working in the new format, and feeling that there were considerable benefits in their ability to respond appropriately to the young people. There was still some concern over ownership of "cases", however, with some pastoral care staff feeling that they should be the overall co-ordinators for all pupils within their remit, and unwilling to relinquish their traditional role. Senior managers and other team members argued that it was more appropriate in some cases for other teachers to play the lead role, for example if the pupil's main issue was associated with a specific learning difficulty.
Relationships between the pupil and parent support workers and the teaching members of the team were not yet fully integrated, which could be ascribed to the different working practices and perceived status of the two groups, and was exacerbated by their locations in separate offices (albeit next door). Whilst, the rhetoric was that of an inclusive extended team, information was not always passed between the two groups in a timely and helpful manner. The support workers were often uneasy or underconfident about raising issues directly with the teaching staff, and would rely on the depute head teacher as an intermediary. Similarly, the support workers relied on the depute, to determine how information should be shared with the wider team. For example, one worker described her response when a pastoral care teacher wanted to see the files she kept on a particular pupil:
We have got files here, they are locked up. Obviously they are there for the support services if they need to get information, but I would speak to [the depute head] first and say "look the guidance teacher wants to have a look at the notes is that OK?"
The pupil and family support workers did not have a senior team member, to take overall responsibility. Their line manager was the depute, on whom they were heavily dependent. This put a considerable workload onto the depute, but also made the whole system very reliant on a single individual, rather undermining the team structure. The system was still at the early stages of implementation and the current weaknesses in this situation were recognised by the depute, and some of the team members, who were working to strengthen the partnership, but there was still some development to be undertaken before the team could be seen to operate as a whole, on an equal footing.
Information sharing throughout the school was treated in ways which contrast sharply with other case studies, the difference being in the attitudes of teachers to confidentiality as compared to workers from other services. The idea of full confidentiality was rejected by the depute head teacher:
I don't want any child feeling they can tell secrets and that they will be kept because it will be shared and it should be shared.
Instead, information was shared on a "need to know" basis, with complex judgements being made about appropriateness, and the benefits to pupils of passing the information on. A high priority was given to providing those working with pupils enough knowledge to be able to respond effectively to any unusual behaviour. Information was handled sensitively and pragmatically. For example, within the support services team, staff would discuss their knowledge of a particular pupil, but that discussion would be confined to those who worked directly with the young person. In passing information from the support services team to the wider teaching staff, sufficient details were given to allow the staff to be sensitive to the child, and to react appropriately to any unusual behaviour, but the full personal story would remain confidential. For example, staff might be told that there were "problems at home", but no more.
The confidentiality was handled selectively depending on judgements of the reliability and empathy of the recipient, as described here:
I might go if I know there is an issue in one department and I know the member of staff the issue is with is a particularly capable and trustworthy member of staff. I might go and say "we have real problems here, this child is a carer at the moment at home". But I wouldn't do that with others because some don't want to know. Some who do want to know are indiscreet, so again it's about knowing your staff. (Depute head teacher)
The emphasis in sharing the information was always based upon the perceived best interest of the pupil; to ensure that the young person was treated sympathetically, and to ensure that the staff were supported in working effectively, but there was clearly a tension between sharing and respecting confidentiality.
Pupils were also shared responsibility in maintaining appropriate confidentiality, since very often more than one pupil was present in room 43. The ground rules were described by one of the pupil and family support workers:
There is confidentiality between the children, and [ ], anything that is discussed. Some might disclose. We don't ask each other questions about why we are in here. Anything that is revealed, it doesn't go outside this room.
Capacity building
This model of working was successful in building the capacity of the school to respond to pupils whose behaviour could be seen as challenging, and there was a strong emphasis on seeking the underlying cause and working with the child and the family to address the issue. The new working arrangements had produced synergistic partnership between the teaching members of the support services team. But the new relationships did not directly involve the wider population of teaching staff, who had very little contact with the pupil and family support workers, and were perhaps only dimly aware of the impact of the reorganised pastoral care system. Although not directly involved with the pastoral care of pupils, teachers were aware of the work, and viewed it with a strong sense of relief both for themselves and for the pupils for whom it was beneficial, as is evident in this excerpt where a teacher contrasts the current situation with the past:
When I first came here you kind of struggled on and on with kids with horrendous problems and there was very little to do, short of excluding them repeatedly, whereas now there is room 43 where they can go and know they can go and they are going to get somebody to listen to them.
And as teachers they felt they were more able to respond appropriately to specific pupils as a result of the information that was circulated by the support services team about vulnerable pupils, and they also demonstrated a level of sympathy and understanding for those pupils. But the existence of such a support team had not, they felt impacted on their own attitudes or pedagogical approaches. They identified a dilemma in accommodating the behaviour of the troubled young people whilst trying to maintain the usual curriculum and standards of discipline for the rest of the class.
You do sometimes get very frustrated when you have to tread on eggshells with some kid because they don't have a very happy existence. And it does start to affect the others and that is frustrating.
And they were aware of the difficulty in identifying causes behind particular behaviours, at the time of occurrence and the potential for misinterpreting and mishandling issues:
Sometimes you do go in with all guns blazing to some creature that is not behaving very well. And then after there is a big bust up you find out that there is a reason for all of this, that there is an excuse.
Whilst the teachers felt they would like to be able to support these pupils more effectively, they felt that the demands of the curriculum coupled with the lack of resources made it very difficult to provide an environment which could effectively support pupils:
Its quite difficult to take these kids and give them a more positive experience because they are in a standard grade general / foundation class with twenty nine other kids.
In the context of this dilemma, a certain sympathy was expressed for pupils who didn't behave well in the classroom
If you stick some poor sod in the back of a full history class and he has just come from seeing his dad, and he is having to take notes on the Russian Revolution and he cannae cope with it, its all going whoosh, you can understand why they take off like a firework.
So whilst the school had been successful in working with young people individually through the various aspects of the support services team, it was still restricted in its ability to offer a more appropriate classroom environment for those pupils, and as yet, the increased capacity of the pastoral care system to respond to the needs of young people and their families, had not been matched with increasing the capacity of the wider school to understand and work with these issues.
Stakeholder involvement
A major plank of the work of the support services team was to build closer relationships between the home and the school, and the way this had been approached was to employ a team of pupil and family support workers who were not qualified professionals, but were "typical" local people. This was intended to create a workforce who understood the local context, who would not seem intimidating to parents, and who, significantly, did not have any powers to remove children from their families. One of the pupil and family support workers described how she saw her relationship with the families:
Maybe its just our own background, like the way we have been brought up ourselves or whatever; maybe we grew up in kind of similar backgrounds to the people that we go to visit. And maybe we just… we don't see ourselves…we don't try to make ourselves any different from the folk that we are going to see.
Although they acknowledged that there were occasions on which they weren't welcomed into household, this was seen by the team to be a generally successful approach, and those parents who had experience of the group spoke extremely highly of the support received. The following passage describes a mother's impressions of the support she received at a time when her son was behaving very aggressively at home:
They are absolutely the best thing since sliced bread. Totally amazing. What they do is they'll come in and speak to the family. …. I had personal contact numbers I could phone at any time. They would come and speak to him [my son], and the family support worker would take him for a wee walk, and she would say to him "How do you feel about this, why's this been happening?" and little by little the behaviour started to disappear. I was phoning this woman and saying " You need to talk to him I don't know what to do". It was a great safety net for me. I was starting to think "I've got no parenting skills" I was losing all my confidence…I was running this by this person who was saying to me "You're absolutely right that's what anybody would do". And that's what I'm talking about, somebody being encouraging. And this service in this school I have found totally amazing.
The pupil and family support team could be accessed by parents in various ways, including direct contact by telephone, indirect approaches via senior management in primary and secondary schools, or referrals from other services such as health visitors. A leaflet was widely distributed, to explain the role of the team and how to make contact. Consequently, the service was readily accessible, and its use by parents was not controlled by any single gatekeeper. It was reported, by the depute headteacher that parental self referral was becoming increasingly common, as the service became embedded.
The approach taken by the workers was a non judgmental, listening approach, only advising if asked. They were trained to use the language of a shared responsibility, phrasing questions in terms of "what shall we do", and they were able to be respond in flexible ways to issues arising in individual cases.
Similarly work with children in the school setting took a very child centred approach, trying to work with the pupils to determine the root causes of the difficulties they were having. Undisciplined classroom behaviour was viewed as a manifestation of an underlying problem, and the team saw it as their role to support the pupil with that issue. There was a clear understanding of the links between emotional well being and behaviour. Pupils were encouraged to take some ownership of their relationship with the team, for example by involvement in target setting, by choosing whether to use room 43 at breaktimes, and in some cases the pupils were able to choose those moments when they left the classroom to come down to the pupils support room.
Summary: strengths and challenges
- At Clydebank High school the ownership of the support for pupils and families lies with the school, and is managed by a depute head teacher. The model has developed the capacity of existing support staff building much closer links between pastoral care, behaviour support and support for learning. Additionally the school employs a team of pupil and family support workers who work both proactively and reactively with targeted pupils and families.
- Currently the system is highly dependent on the depute head teacher who acts as a conduit for information flow between the two arms of the team, and between the team and the wider school. She has been an enthusiastic champion of the team from the outset.
- Tensions are identified between the pupil centred approaches taken by the support services team which enable some children to remain in school, and the difficulties teachers face in providing an appropriate classroom environment for these pupils, whilst also meeting the needs of the majority.
- The pupil and family support workers have developed successful ways of working with families and young people, which are premised on supporting emotional health and well being. The value of the pupil and family support workers to the well being of young people in the school is belied by their perceived status, which currently leaves them feeling somewhat outside of the main professional community, and gives little opportunity for sharing of ideas beyond their immediate colleagues.
- Attitudes to sharing information about pupils were pragmatic, with priority given to enabling staff to be able to respond appropriately to pupils' behaviour. Full confidentiality was not considered appropriate. Staff in different positions in the school were informed differentially on a "need to know basis" coupled with judgements about the discretion of the individual. But clear tensions could be seen between protecting the child's privacy and enabling the teachers to respond sensitively.
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