Implementing the emotional evidence base into practice- lessons from
Newham –EBPU Seminar
Dr Simon Munk
CYP Mental health and Resilience Strategic lead, London Borough
of Newham
CYP resilience programme lead, UCLPartners
Simon.munk@newham.gov.uk
Will cover
17:15-17:20- Who’s in the room
17:15-18:00-Interactive presentation
• What is emotional resilience
• Why it matters to us in Newham
• Lessons from piloting three different resilience promoting
interventions in Newham
18:05-18:20- Questions
18:20-18:35- Table discussion
• What is the relevance to you locally?
18:35-19:00- Networking and further discussion if interested over tea
What is resilience?
“Positive adaptation to adversity despite serious threats to adaptation or
development’
(Masten)
Often best understood as a set of competencies- rather than one thing. These include:
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Positive school connnectedness
Positive connectedness with individuals and activities in community
Positive peer connectedness
Positive home and family connectedness
Autonomy
Positive self esteem
Empathy
Problem solving skills
Aspiration
Why does resilience matter?
Competencies important in own right.
Also Evidence that these resilience competencies lead to:
– Reduction in mental health disorder (Schucksmith et al (2007))
– Improved behaviour and attendance at school (Adi, Y., Schrader McMillan, A., Killoran, A.
and Stewart-Brown, S. (2007)
– Reduction in Risky behaviours (Catalano, R., Berglund, M.L., Ryan, G.A.M., Lonczak, H.S. and Hawkins,
J.D. (2002))
• Newham has high level of risk factors for development of mental
health disorder and risky behaviour taking
• Great political desire for prevention and early interventions which
have been locally demonstrated to reduce level of specialist CAMHs
interventions and social care interventions.
Newham HeadStart Programme Intro
• Big Lottery funded HeadStart Pilot Programme
has been working across 16 primary and
secondary schools and multiple community
settings over last 12 months to pilot and evaluate
different approaches to promoting emotional
resilience in 10-16 year old pupils at risk of
developing mental health difficulties
• I describe today three of them focussing on why
we chose the intervention, what we did,
challenges, outcomes and wider learning for
others seeking to do the same.
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HeadStart Programme Objectives
Delivery of evidence based approaches which promote emotional resilience
in 10-16 year olds at risk of developing mental health difficulties which leads
to:
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Reduction in Mental Health disorder
Improved school attainment + attendance
Reduction in risky behaviours (improved social care and YOT outcomes)
Reduction in NEET
In addition the programme is seeking to deliver:
• Increased whole school staff competency to promote resilience
• Increased parent/carer competency to promote resilience
• Increased employment opportunities for parents as peer facilitators
Ultimately aiming to make the case for ongoing local funding of programme
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Newham HeadStart pilots
Training and support for school staff to increase their capacity
to promote the resilience of their pupils
Peer led training and support for parents of young people to
increase their capacity to promote resilience
A supported volunteering programme to help young people engage
in their local community
A young-person led borough wide multi-channel
resilience campaign
Peer Mentors trained and supported to increase their capacity to
promote the resilience of their mentees
Why a Peer mentoring pilot
• Evidence that 1:1 mentoring can promote resilience competencies
in both mentors and mentees and that this can lead to improved
mental health, educational and social outcomes
• Specifically these resilience competencies are increased
connectedness in school, the community and the family (Gordon et
al., 2013; Randolph & Johnson, 2008)
• Peer mentoring in particular shown to produce increased
opportunities to reach higher-risk children.
• Many different peer mentoring programs exist. It is apparent that a
number of key elements distinguish programs with better outcomes
from those with neutral or detrimental outcomes (Rhodes, 2005)
(Gordon et al., 2013; Randolph & Johnson, 2008)
• It was unclear to us that there was a best practice peer mentoring
model available and we sought to develop our own.
Development of local best practice model
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A literature review conducted by UCL (Podmore, Munk, Fonagy, 2015) helped us to
understand what the key components which made a peer mentoring programme
effective were:
These were categorised into how to recruit appropriate mentors and mentees, how to
train and supervise the peer mentors and how to support and maintain the mentoring
relationship.
A expert development group of psychologists, youth practitioners and school staff
worked with a group of trained peer researchers to understand these key components
and crucially to understand how they could be implemented in a relevant way in the
local context.
Evidence that involvement of beneficiaries in the adapting of interventions leads to
increased compliance. (Day, Carey, & Surgenor, 2006; Fotaki et al., 2005
Lessons from this peer review were then then used to develop a manualised peer
mentoring model based on this co-design work. This included recruitment processes,
mentor training and supervision materials and group based activities to support the 1:1
mentoring activities.
The model is delivered by peer mentors who are trained and supervised by a local
psychologist and youth practitioner.
The next slide summarises this development process.
Bringing together evidence and views of beneficiaries
Example lessons from narrative review
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Mentors should be screened for engagement
with purpose of the program. Individuals with
an interest in joining “caring professions” are
more likely to remain committed to the program
(Bodin & Leifman, 2011)
Some evidence that youth who present with
more intermediate levels of challenge rather
than youth for who such difficulties were either
severe or relatively absent are more likely to
benefit from mentoring programs (DuBois &
Karcher, 2013; Schwartz, Rhodes, Chan, &
Herrera, 2011)
Mentors should be able to promote the mentee’s
ability to develop positive natural mentoring
relationships with surrounding peers and adults
(DuBois & Silverthorn, 2005; Zimmerman et
al., 2005)
Mentoring programs need to consider how to
develop positive youth development
competencies in the mentees (Maslow &
Chung, 2013; Theokas & Lerner, 2006a)
Ongoing mentor training during program is vital
to maintain quality but is not common (DuBois
et al., 2002)
Ongoing training is imperative to ensure good
quality relationship. Experiential learninginvolving the mentor and mentee can be
effective. This can start with small scale
exercises and progress to larger exercises. Role
Example implementation lessons from peer
research
 Caring and trustworthy, honest, reliable, nonjudgmental and active listening are vital
criteria
 Mentor should be friendly but professional
and not a friend
 Practical reasons to be a mentor- good for
CV, good for development of life skills
 Ex-mentees may be inspired to become
mentors
 People with emotional difficulties feel
isolated and want practical and want a
mentor for emotional support
Developed program component
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How to build trust even if little in common?
Communication skills are a high priority
Understanding of the change in the role of
the mentor, from first few sessions building
the relationship through activities to then
starting support and challenge the mentee
Mentor training
Delivered by a positive psychology
practitioner- provides mentors with
toolkit to build positive relationship
with mentee and support positive
behavior change
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Want to be able to go to supervisor for
support and advice
Mentor wants to feel supported and safe,
especially in first few sessions. If then goes
out into community, want to be able to report
back progress
Mentor supervision
Enables the mentors to review the
mentoring and get ideas, advice and
guidance from the supervisors and
peers on areas the mentor and mentee
are finding challenging
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Mentor and mentee recruitment
Recruits peer mentors and mentees
against specified criteria involving
young people in recruitment process
Piloting of model
• The developed model was piloted with 36
students in two local schools (mentors 16-18;
mentees 12-14).
• Evaluation focused on:
• Was there evidence that the intervention
promoted resilience competencies in mentors
and mentees
• Qualitative indicators of the facilitators and
barriers to delivery of the development of the
intervention
Results
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On a validated measure of resilience competencies (student resilience survey)
significant increase in mentees resilience was observed but not of mentors and
high attendance and completion rate was observed in mentors and mentees
Thematic analysis of structured interviews with participants and supporting
individuals gave key clues to how the intervention could be refined to work more
effectively in the local context.
The role of the youth worker and psychologist in delivering the training and
supervision was viewed positively by the young people, as was the role of group
activities in supporting the mentoring activities.
The role of young people in promoting the project as well as delivering the
mentoring was deemed as important in engaging with the target population.
The young people who took part in the acceptability study indicated a number of
challenges that still need to be overcome if the intervention is really going to work
in the local context. There needs to be clearer setting of expectations with the
mentees about the role of the mentor. Thought also needs to be given to how the
mentoring relationship can be made to feel more natural while still being
contained in a safe environment.
Key lessons
More generally:
• When different approaches to delivering an intervention are
available- it is important to understand what are the key
components which are linked to positive outcomes
• In implementing any intervention locally it is important to work
with local professionals and beneficiaries to understand how these
key components can be most effectively delivered
• When evaluating the effectiveness of an intervention vital to use
metrics with validated psychometric properties
• Important to use qualitative evaluation to understand the
facilitators and barriers to delivery of an intervention and how
delivery can be refined.
• Importance of a manualised model which can then be evaluated
and refined as a consequence.
Why a Supported volunteering pilot
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Volunteering programmes or Service-learning interventions are defined as a teaching
and learning strategy that attempts to integrate community service with an academic
curriculum
They have been shown to promote resilience competencies particularly self esteem,
problem solving, community and school connectedness and empathy. (Celio, Durlak,
Dymnicki (2011))
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Whilst many schools encourage pupils to take part in school and community based
community activities anecdotally schools told us that the more vulnerable young
people (our target population) were not taking part.
In addition it was not clear to us that these programmes were adhering to best practice
from the literature .
In particular the above mentioned metanalysis suggested that key components of
successful programmes were those that linked learning back to the curriculum,
provided students with a key voice in developing their own activities, actively involved
the community and provided space for student reflection on the experience.
We sought to work with a commissioned provider of community based youth
volunteering opportunities to develop a manualised approach which incorporated
these elements.
Supported volunteering developed model
• Typically the “wrong” (the most able) young people take part in
such activities The volunteering model we co-developed locally
focussed on youth practitioners working with young people in
schools to promote the opportunity to more vulnerable young
people.
• The developed model supports recruited young people to as a
group co-develop an initial school based volunteering activity which
is followed by a community based activity over a term.
• Time is built in for youth practitioner-pupil 1:1 reflection on the
experience.
• The model also focusses on developing and supporting sustainable
links between the school and surrounding community volunteering
placements.
Pilot findings
• Quantitative evaluation of young people taking part in volunteering pilot
in four schools (age 10-14; 150 participants) showed average significant
increase in resilience on survey (as above)
• High 85% of young people taking part were within our target population
(measured using RONI indicators)
 Qualitative evaluation demonstrated that the project was very well
received by schools and anecdotally school staff noted marked
improvements in behaviour of students who participated in the project.
 A positive impact on local communities who benefit was also observed.
 Evaluation of facilitators and barriers to delivery enabled us to refine
manualised model
 We are now working with the provider to train and supervise locally based
youth practitioners to deliver the manualised model.
Supported volunteering-Key lessons
• Working with the provider to ensure that the delivered model reflected
key evidenced components was important
• Flexibility is required regarding how the model is delivered with schools to
ensure it fits around other priorities
• Key role of beneficiary involvement in co-delivery helps to engage with
vulnerable population
• Key role of youth practitioners in engaging with vulnerable population.
• Having a manualised approach will enable us to train and supervise local
youth practitioners to deliver the model at scale.
• Importance of ensuring that project is open to all student and promoted
as a positive opportunity helps participation not to be experienced as a
stigmatising process. This also ensures that groups are more balanced.
• This has to be balanced with targeted promotion by school staff and youth
practitioners to ensure that it reaches the target population.
Why Whole school approach
• Evidence that the whole school ethos, including behaviour policies, how
vulnerable young people are identified and supported by the whole school
staff can be significant in building resilience competencies and improving
secondary outcomes. (Weare and Nind 2011)
• Evidence that approaches which support schools to develop
improvement plans, policies, systems and activities which are explicitly
designed to promote social and emotional wellbeing do indeed promote
resilience competencies.
• However there are lack of robustly evaluated models for implementing
such whole school training and organisational development approaches.
• We sought to work with a provider to develop a model which:
– Builds whole school staff competency to identify vulnerable pupils and
support them to develop a number of resilience competencies
including aspiration, self-esteem and school and community
connection.
– Support the school through a service improvement/organisational
development approach to develop new policies, initiatives and ways of
working
Whole school staff training- pilot findings
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We piloted this approach with a mix of ten primary and secondary schools
supported by our provider.
We trained a large number and variety of staff across the schools and it was very
positively received.
Staff consistently reported feeling more able to identify need and to promote
resilience competencies following the training. However a lack of psychometrically
validated measures to assess these staff competencies made it challenging to
assess the effectiveness of the training.
The whole school organisational development approach involved all levels of the
school (including pupil involvement) auditing current practice and through this
each school developed an action plan for change.
The school SLT was then supported by an expert external facilitator to implement
the action plan.
The approach has been popular with schools who see the very clear links between
this, behaviour management and improved attendance and attainment.
It is as yet unclear whether these action plans are leading to measurable change in
the school.
Whole school staff training- key lessons
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The evidence suggests the importance of changing the whole school ethos if
targeted interventions such as mentoring and volunteering are going to work. The
challenge however is that supporting a school to change its ethos places high
demands on the school.
It is also challenging to manualise such an approach as a bespoke approach is
important dependent on where the school is at baseline.
However it has still been important to define the key components of the
intervention so that these can be evaluated and refined as well as for quality
assurance.
It has also been important to be able to clearly define to schools what the
approach involves.
The expertise of the external facilitator both in terms of their knowledge and
ability/credibility to drive change in the school has been crucial.
The role of pupils in contributing to the baseline audit process has also been vital
in challenging the schools about current practice.
The lack of validated measures of staff competency to promote resilience has
made it difficult to assess the effectiveness of the training and thus to be able to
refine the model.
Discussion
In small tables (15mins including tea)
1) What has been your experience of attempting
to set up or deliver new interventions? Do
reflections from Newham resonate?
2) What could you take home from the Newham
experience?
Newham roll out programme- if time/interest
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Currently applying for funding from Big Lottery to establish a borough wide multifaceted programme which aims to promote resilience in 10-16 year olds with low
emotional wellbeing
Will be based on learning from the pilots both in terms of which interventions
work locally but also the key implementation lessons (some described above)
Key to success of this programme will be being able to demonstrate that the
interventions not only promote resilience but that this leads to improved mental
health and educational outcomes as well as a reduction in risky behaviours.
We hope through doing this that we will be able to make a strong business case to
education, health and social care commissioners for ongoing investment.
To enable this impact to be demonstrated we will be regularly measuring resilience
and mental health symptoms in all students taking part. This data will be matched
with existing education and social care data sets.
Analysis will enable us to refine the programme delivery as well as evaluate the
impact of individual interventions.
In addition it will enable us to assess whether the interventions are additive in
value.
Collecting, matching and analysing data to demonstrate impact