Opening the webinar, Dr Bonnie Teague, head of research at Norfolk and Suffolk NHS Foundation Trust, explained that the Mental Health Implementation Network (MHIN) was set up to catalyse and evaluate the implementation of existing, evidence-based mental health interventions across the UK.
The implementation of Parent-led Cognitive Behavioural Therapy (PL-CBT) in school settings, or the ‘Working on Worries’ project, is one of three projects that the MHIN has worked on over a five-year period.
PL-CBT is an effective and cost-efficient treatment for childhood anxiety where therapists work alongside parents to empower them to use CBT tools at home with their children.
Dr Chloe Chessell, a psychological wellbeing practitioner and researcher at the University of Oxford, explained that the intervention can be delivered in a book-based format or through an online programme. It has been shown to take substantially less therapist time to deliver than usual treatment, without compromising child outcomes or parent satisfaction.
“50% of anxiety disorder cases begin before the age of 12” said Tom Rhodes, study manager of the Working on Worries project. “There is limited access to evidence-based interventions in schools, and school staff lack training to meet the needs of children waiting for support from services. So, what we were aiming to do with this project is to support pastoral workers and primary schools across Norfolk and Waveney to implement existing PL-CBT approaches.”
Using a ‘train the trainer’ model, 220 pastoral and school staff across 130 primary schools were trained by external children and young people's mental health practitioners to be able to work with parents in schools using CBT approaches.
School staff reported that having prior existing relationships with parents, carers and children meant they were well placed to identify who the intervention would be useful for. They found that using the intervention helped build positive relationships with parents, support children quickly and reduce onward referrals to specialist mental health teams.
It has had a huge impact. It just helped change how I approach situations. I've learned coping strategies for my children and myself. It has really been an amazing support to all of our family.
It has been really good. We have definitely seen a change in our daughter. We understand how to deal with her anxieties and how to support her in future. Family life is less stressful.
Rachel McGuire and Alexia Zinonos-Lee, who led the project’s Parent and Carer Advisory Group, (PCAG lead) shared an animation that was co-produced by parents and carers and children involved in the work. “Doing a participatory animation felt like a really good way to give children the chance to express how they make sense of a parent-led CBT programme,” explained Rachel McGuire.
We asked the children of our parent and carer advisory group members what they would like to know if they were told that they were going to do an intervention like this. So, they came up with the questions for us. We then gave those questions to children who had done the intervention, and they answered them. So… in effect, we had nothing to do with this part of the process!
In the final section of the webinar, Dr Kathryn Berzins, a mixed-methods mental health and social care services researcher and reader at NIHR ARC North West Coast, shared updates about the implementation toolkit the Working on Worries team have created as a key output of the project.
An implementation toolkit is a collection of resources designed to support the successful wider implementation of a new intervention, often including educational materials, templates, frequently asked questions and evaluation advice. The guide is currently being tested in school settings and with service commissioners and will be available for wider dissemination soon.