Project MH41

Working on Worries (WoW) implementation project: enhancing collaboroation between the health and education systems to increase access to parent-led CBT for child anxiety in Norfolk and Waveney

Evidence-based interventions for child anxiety are not well accessed. Parent-delivered CBT for child anxiety is an approach that can be delivered by novice therapists. We used implementation methodologies and strategies to identify, train and support pastoral workers in primary schools across Norfolk & Waveney and monitor implementation outcomes.


Childhood anxiety disorders are common and have a negative impact on educational, social and health outcomes. There are evidence-based treatments for childhood anxiety disorders, but most families are currently unable to access them. Parent-led Cognitive Behavioural Therapy (CBT) for child anxiety is a brief intervention with a strong evidence base that can be successfully delivered by novice therapists without specialised training.

Project Aims

We aimed to improve access to parent-led CBT for child anxiety in Norfolk and Waveney through enhancing collaboration between the health and education systems. Focusing on schools in areas of high need, we supported the Norfolk and Waveney mental health system to provide training and ongoing collaborative learning to enable school pastoral support workers to deliver parent-led CBT within their schools. We used implementation science to optimise delivery and sustainability, and evaluated the process and outcomes to inform iterative improvement and future implementation.

Project Activity

  • We identified pastoral workers across N&W that would like to offer this intervention to parents/carers of children in their schools with anxiety difficulties.
  • We trained mental health workers as trainers to ensure sustainability and provide ongoing collaborative learning and support sessions (CLaSS)
  • As an implementation project we measured implementation outcomes

Anticipated outputs

  • We trained 75-100 pastoral workers to deliver this intervention and further immediately expanded / improved access of this evidence-based intervention.
  • Anticipated outputs include sharing learning via national networks to support wider national rollout as well as traditional publications

Who was involved?

  • Dr Tim Clarke (Co-Lead, NSFT and N&W ICB) - Corresponding researcher
  • Dr Jon Wilson (Co-Lead, NSFT)
  • Dr Brioney Gee (Co-Lead, NSFT)
  • Dr Bonnie Teague (Co-Lead, NSFT)
  • Ella Mickleborough (Project Research Associate, NSFT)
  • Luke Wrigley (Project Assistant Psychologist, N&W ICB)
  • Prof Kristy Sanderson (UEA, ARC)
  • Eastern AHSN

Contact us

Dr Tim Clarke, Norfolk and Suffolk NHS Foundation Trust