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.
Background
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. Initially 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 to provide ongoing collaborative learning and support sessions (CLaSS).
- As an implementation project we measured implementation outcomes.
Impacts
- We trained 107 school-based pastoral and support staff to deliver this intervention across 78 primary schools in N&W from January 2023-December 2023.
- Trained 22 mental health professionals to serve as trainers and to support the implementation of the intervention.
- Intervention was delivered to 87 families by the end of December 2023.
- Expanded access to this evidence-based intervention.
- Collected data on effective strategies to implement this intervention within primary schools through existing pastoral and support positions.
Outputs
- Shared learning via national networks to support wider national rollout.
- Traditional publication concerning our results is currently being prepared.
Continuation/Next Steps
- Received additional funding from the local ICB to further expand access to the intervention through additional waves of training available to all primary schools in N&W. To date, 216 school staff have been trained across 125 primary schools with 189 recorded cases of intervention delivery.
- Provide recommendations to support sustainment of the intervention within primary schools after the end of project support.
- Received further MHIN funding for the creation of an implementation guide and toolkit to support wider rollout of the intervention in other regions.
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)
- Tom Rhodes (Study Manager, NSFT)
- Luke Wrigley (Project Assistant Psychologist, N&W ICB)
- Theodore Koda (Research Assistant Psychologist, NSFT)
- Chloe Chessell (University of Oxford)
- Prof Kristy Sanderson (UEA, ARC)
- Eastern AHSN
Contact
Dr Tim Clarke, Norfolk and Suffolk NHS Foundation Trust
