ARC EoE co-collaborators Dr Tim Clarke and Dr Brioney Gee share how mental health researchers have partnered with schools and parents to improve access to therapy for children’s worries and anxiety problems.
Dr Tim Clarke works as a research clinical psychologist and clinical advisor for children and young people’s mental health with NHS England, local NHS and Norfolk and Suffolk NHS Foundation Trust (NSFT). Tim is a former ARC EoE research and implementation fellow and focuses on bridging and reducing the gap between research, innovation and clinical practice, collaborating with the ARC EoE mental health theme as implementation and strategic lead for the Working on Worries (WoW) project.
Dr Brioney Gee is one of the research development leads at NSFT. The Trust’s research development programme works with service users, clinicians, and the local community to co-design mental health research projects to address real world priorities. Brioney focuses on the mental health needs of children, young people and their families, and is working to improve access to mental health support through interventions that sit outside of traditional NHS settings.
How the Working on Worries project developed
At a children and young people’s mental health conference in 2019 organised by UEA Health and Social Care Partners, we heard from staff at the Nebula Federation of primary schools in Norfolk that further support was needed to help children and their families with fears and worries. As part of Tim’s ARC EoE implementation fellowship, we worked with NSFT colleague Dr Jon Wilson and Nebula teaching staff and pastoral leads to develop possible solutions.
In 2021, we engaged with local partners and stakeholders, including parents and carers, to understand what support they need to help children with mental health difficulties.
One of the key reflections was that parents/carers are well placed to support them at home and want to know more about how to do this. Pastoral staff in schools are already supporting parents and carers to help their children with fears and worries, but need more tools and resources to deliver support that is evidence-based.
Dr Tim Clarke and Dr Brioney Gee, ARC EoE co-collaborators
We decided to pilot a training programme for pastoral staff in the Nebula Federation of schools to enable them to deliver a Cognitive Behavioural Therapy (CBT) based intervention for anxiety, called Helping Your Child. This approach was developed by Professor Cathy Creswell and her team at the University of Oxford to help parents manage child anxiety problems and is backed by some great results in high quality research studies.
In 2020, we worked with Katie Thompson at Ormiston Families (a charity in Norfolk delivering mental health support to children) to train pastoral staff to deliver this approach and continued to support them as they identified and worked with parents/carers of children with anxiety difficulties.
During the pilot, we learned a lot about how this approach works in schools and the experience of parents/carers and pastoral workers in applying it. We were also glad to find it helped to reduce the impact of anxiety for children so they could progress towards their goals.
Tim reported on this pilot at the 2021 ARC EoE Fellows Showcase and the Working on Worries (WoW) implementation project developed from these findings to expand the approach to more primary school pastoral staff across Norfolk and Waveney. Our NSFT Research team worked with ARC EoE to successfully apply for NIHR Mental Health Implementation Network (MHIN) funding to support the evaluation of this rollout as well as securing funding to continue implementing the approach from the Norfolk and Waveney Integrated Care Board.
We hope that by training pastoral workers in schools to deliver this evidence-based approach, we can improve access to effective therapy for children with anxiety difficulties. If families are offered support as early as possible, it may help to prevent these problems getting worse.
Dr Tim Clarke and Dr Brioney Gee, ARC EoE co-collaborators
We also hope that it will strengthen relationships between schools and the health system as they work with our trained mental health clinicians to add this approach to their toolkit.
Progress so far and next steps
We are just finishing the process of identifying schools to offer training and support to deliver this approach and are currently training pastoral workers. Most schools we have approached see the value of this intervention and have been very encouraging. Where schools haven’t been able to get involved, the main barriers are a lack of capacity for staff to be released for two to three days training and then put into practice what they have learned.
We have a robust implementation and evaluation plan and are starting to collect implementation data, which we will monitor throughout the project to ensure it is making a difference. We have also started to offer Collaborative Learning and Support Sessions (CLaSS) to trained pastoral workers who have started delivering the intervention. This follow up support is helping them apply and maintain the approach in their schools.
This implementation project (WoW) is unique, but through the NIHR MHIN workstream we are working with another team in North West England who are also learning about applying the same approach but with a different workforce. We are also collaborating with teams leading related projects to share our learning and to influence future directions of this approach.
If you would like to find out more about our project and learning so far, please contact: workingonworries@nsft.nhs.uk.
