Introduction

Linhope is the Pupil Referral Unit in Newcastle for boys and girls of compulsory school age and serves a community in a LA which is in the most deprived 10% in the country. Almost 1/3 of the population lives in the 10% most deprived areas nationally. In some areas there are over 50% of households where no adult works. The number of learners on free school meals is often around 80% reflecting this high level of social deprivation.

The highest incidence of reasons for exclusion in 2008-9 was physical assault against an adult, then physical assault against a pupil and persistent disruptive behaviour.

On admission, a significant number of learners are within the criminal justice system, and supported by the YOT and a number of LAC this year were 7. All learners are deemed to be at SA+ when they are admitted. Some arrive at SA+; some schools have learners at SA+ but have not been validated by the LA.

Almost all learners attending Linhope have/will have experienced severe emotional, social and/or behavioural difficulties at some stage in their school life and this will be their primary need. This primary need will, however, have impacted on their engagement in education, their progress and attainment and their interaction within their community at family, school, and friendship levels.

Some learners have been out of school for significant periods of time (some for over a year) and consequently, many are functioning at a level lower than national expectations for their age on entry to Linhope.

Other tools for measuring emotional literacy and personal development have been introduced.

Aims / Ethos –

Linhope aims to ensure all learners access pathways to the most suitable provision at the appropriate time. This may be back to mainstream or on to segregated provision for learners with ESBD, whichever is more suitable to their needs. Regular multi-professional Tracking Meetings chaired by the DHT ensure that learners are identified and actions taken to provide an educational placement suited to their needs.

Our Mission Statement affirms our belief that all children have the right to education and that we exist to provide opportunities (relating to academic, personal development and behaviour management) for those learners whose education has been interrupted for a variety of reasons. We try to ensure that any educational disadvantage is minimised by providing high quality, structured and appropriate learning opportunities in partnership with parents and other schools and providers, in a caring and well-resourced environment.

We have an ethos that encourages and helps to develop self-management, self-reliance, mutual support, respect, confidence-building and self-esteem, where everyone is valued as an individual. Pro-social behaviour is encouraged in a supportive environment. We provide equality of opportunity to all at Linhope, firmly tackling discrimination; we are a fully inclusive provision and we can adapt quickly to the changing requirements of the learners in our care.

During the last ten years of working with Children and Young People (CYP) with social, emotional and behavioural difficulties I have had first hand experience of witnessing the links between their emotional well being and its impact on their learning, achievement, relationships and resilience. I have discovered that how a child thinks about themselves, other people and the world around them affects how they feel and how they behave. I believe feeling, thinking and behaviour interact with each other and emotions have a core role to play in how a child functions. My current stance can be summed by the following quote:

In recent years schools have reported much higher levels of challenging behaviour from children and young people as well as a marked increase in stress, depression, anxiety and self harm often leading to worrying behaviour and an inability to learn. With the ‘Every Child Matters’ agenda now firmly in place and the additional responsibilities that this places on schools, there is often from them a cry for help, advice and support. Schools feel themselves in the frontline of tackling the emotional needs and mental health of the young and can feel quite anxious and isolated.

(Emotional Well-being and Mental Health Support For Children & Young People in Schools)

Through my role as PSHE co-ordinator, I believe that the skills, knowledge and understanding taught through this subject are fundamental to the development of the child. However, I also believe that the Emotional Health and Wellbeing (EHWB) aspect of the PSHE curriculum has a significant influence on the development of the child and young person (CYP), as well as important consequences for health and social outcomes later in life. This view is echoed by Brennathan (2002)

Under the prevailing teaching culture of ‘stimulate them and they will learn’ schools took for granted levels of self-management and social skills which many children did not have…students who are anxious, angry or depressed don’t learn; people who are in these states do not take in information efficiently or deal with it well…when emotions overwhelm concentration what is being swamped is the metal capacity… the ability to hold in mind all the information relevant to the task in hand’.

In response to this I have put into place a number of strategies which try to measure and address the EHWB of the students at Linhope including; Emotional Literacy Assessment, ABC observation sheets, PSHE Skills, Knowledge and Understanding Teacher Assessment, SEAL activities and, of course, an inclusive and supportive learning environment. This has allowed me and others to identify what skills and competences the CYP already have and identify areas of weakness and prioritisation. The significant challenge that I now find before me is to find workable interventions and appropriate resources which are designed specifically for children who’s social, emotional and behavioural needs fall short of their peers. This is not an easy task given the complex nature of the CYPs social worlds, the stresses and challenges of their lives and their often entrenched behaviours and attitudes.

In this literature review I will be outlining and critiquing the provision of past and current interventions and strategies for securing the EHWB of CYP. Alongside this, I will try to discover what provision, if any, addresses those groups of CYP with additional emotional and behavioural needs.

EHWB is known by a variety of terms including emotional literacy and mental wellbeing. Within the Healthy Schools (date?) guidance it is considered as a continuum that includes the range of mental health from mental wellbeing to mental ill health. For this review I will use the description given by the NHS in Scotland which describes EHWB as:

Emotional wellbeing (including happiness, confidence and the opposite of depression) Psychological wellbeing (including autonomy, problem solving, resilience and attentiveness/involvement) Social wellbeing (good relationships with others, and the opposite of conduct disorder, delinquency, interpersonal violence and bullying)

(NHS Scotland (2006) Monitoring positive mental health, NHS Scotland).

At the end of 2007, the UK government introduced The Children’s Plan, a document that lays down strategies for ‘securing the wellbeing and health’ of young people in the 21st century. As it so often is, education is described as a key part of this plan in which schools must build a curriculum to ensure that all children ‘develop the social and emotional skills they need to succeed’. The Children’s Plan also states that, to achieve its aims, school staff will need to be involved in a continuing programme of professional development. This should mean finding out about new ideas, methods and techniques that could enhance the learning experience and, where this is achieved, sharing good practice with colleagues.

Taking this into consideration, I agreed in principle that the EHWB of children should be one of the primary aims of education and has, for a long time, already been at the heart of what school is all about. The issue was, at this point in time, where can one find out about new ideas and strategies that would address the challenging needs of these particular children. Subsequently, over the years through personal research I discovered a number of strategies which I put in place at Linhope. The first framework was and is the Emotional Literacy: Assessment and Intervention which enables staff to identify in CYP aspects of emotional literacy needing attention through the use of three checklists. The purpose of this individual student assessment is to target areas of strength and weakness with a view to intervening in some way that will enable the CYP acquire the skills and competences to develop areas of EHWB. This framework is based on the social, emotional and behavioural skills categorised by Goleman (1995). The categories or ‘domains’ that he uses are: self awareness, managing feelings, motivation, empathy and social skills (including communication). The first three domains, Goleman describes as primarily ‘intrapersonal skills’; those that we use for self-direction. The final two are regarded as primarily ‘interpersonal’ skills; those that we use when relating to others. Although Goleman is one of the most commonly accepted ways of categorising these skills, in my opinion, they have been beneficial in formulating a picture of a student’s emotional and social development such as their progress in terms of making and sustaining friendships, resolving conflicts, communicating affectively, taking responsibility for what they do, making wise choices and learning to their best ability.

Goleman, goes further to describe that within each domain there are a number of individual skills, which change and develop with age and according to the culture in which we grow. This again is particularly informative for the staff at Linhope. Often as is shown by the PSHE Teacher Assessment, many of the CYP fall below the level of skills, attitudes and understanding as their peers. Also, the student’s sense of reality is so different from our own due to the social conditioning of socio-economic background and family circumstances.

The second strategy used at Linhope is trying to understand the purpose of a student’s behaviour when they get into conflict or confrontation in the classroom. This is deemed important because in my opinion, understanding what lies behind behaviours enables myself and others to respond more appropriately. This strategy is based on the fairly universal recognised law in psychology that our behaviour is influenced by consequences. The law of reinforcement suggests that the probability of behaviour increases if it is rewarded, and conversely that it is lessened if the behaviour is punished. For a variety of mainly ethical reasons, rewarding appropriate behaviour, at Linhope, is believed to be more effective than punishing inappropriate behaviour. Skinner (1974) was one of the influential behaviourists who highlighted the significant role of environmental influences in behaviour. He focused on the relationship between antecedents (setting conditions), consequences (reinforcement) and behaviour and the theory became known as ‘operant conditioning’. I tend to view Skinner’s theory as rather simplistic in the sense that if a certain behaviour increases in frequency because it is followed by positive consequences, or not followed by negative consequences, then there would be far fewer children being excluded from school. However, Skinner’s theory was later extended by Bandura (1977) who recognised the importance of cognitive processes which culminated in the development of the social learning theory. Importantly, this theory emphasised that learning could occur by an individual watching someone else and then using ‘self-reinforcement’ to internalise what they had learnt. I consider two constructive elements can be derived from these theories and applied to the teaching of EHWB; from Skinner, the idea of limit setting and from Bandura, the modelling of positive interactions.

Taking these ideas into consideration, this second framework is used when a student is causing concern and their behaviour needs to be analysed in terms of A (Antecedent) and C (consequences). The reasons behind the student’s behaviour is assessed using Rudol Dreikurs: Goals of behaviour (date). Rudolf Dreikurs, an American psychiatrist, suggests that all behaviour has a goal or purpose. Dreikurs proposes that the need to belong is the fundamental motivator of human behaviour and, consequently, that children’s misbehaviour is often a response to feeling that they do not belong in the social context in which they find themselves. This is sometimes called the ‘communicative function of behaviour’. The task of the teacher is to try to work out what legitimate need a bad behaviour is trying to achieve. In Dreikur’s view, they react to this feeling in a number of different ways; including attention seeking, power seeking, avoiding failure, seeking revenge and acceptance and affiliation. Dreikurs ‘goal’s have been informative in deciphering the motives behind the behaviour of the student causing concern, however, it could be argued that behaviour can not and should not be narrowed down to these six responses and by doing so might mean other legitimate purposes being over looked. Similarly, it could be construed that analysing the motivator behind behaviour is merely a subjective opinion from the observer.

The third strategy introduced at Linhope is practised and taught on a regular basis. This involves the direct teaching of the skills and competences needed for EHWB of the students. In other areas of learning, we tend to start with a clear idea of what we are trying to teach, we devise methods to do this and give students plenty of practice with feedback to guide their performance. In my view, the same principles can be applied to EHWB. We can, therefore, show the student what to do by a more experienced and competent person; we can provide a supportive environment in which they can practise and receive feedback to develop the skill until it becomes an automatic part of their repertoire. In other words, EHWB skills can and should be taught and deployed alongside the key thinking skills that students need to tackle the curriculum.

The direct teaching of the skills and competences is, at present, using the Wave 2 aspects of the SEAL. The DCSF has developed the well known Social and Emotional Aspects of Learning (SEAL) for primary and secondary schools, as part of the National Behaviour and Attendance Strategy. The DCSF describes provision of SEAL in terms of three waves. Wave 1 SEAL is class based teaching to address the needs experienced by all CYP in mainstream education. Wave 2 SEAL involves smaller group work which addresses the needs of vulnerable CYP that need additional support above universal needs; such as children with emotional behavioural difficulties, children on the autistic spectrum and children requiring speech and language support. Wave 3 SEAL involves specialist targeted intervention for the most vulnerable children; such as, looked after children, children on the Child Protection Register and children with mental health or drugs problems.

SEAL is described as a comprehensive approach to promoting the emotional and social skills that underpin effective learning, positive behaviour and EHWB in schools. It is based on the notion, mentioned previously, that explicit teaching and implicit promoting of the skills will amount to the most effective learning opportunities. However, a key recommendation of the DfES report, has important implications for Linhope; stating that schools should “ensure that work they organise to promote emotional and social competence and wellbeing is tailored to be appropriate to the age and emotional and social stage of the learner, and that they take positive steps to find out where pupils are starting from? (Weare and Gray, 2003: 55).

It appears that the dominant methods within the SEAL resource rely upon a capacity and willingness on the part of the students not just to recognise and manage feelings, but to talk about them as well. For many students at Linhope, however, a repeated focus on introspection and self-evaluation may be at best uncomfortable and at worst even distressing. Also, the majority of learning tasks are socially organised, and learners need good social and communication skills to manage these aspects of working together and learning from and with others.

Again, many students at Linhope, have poor communication skills and do not possess the skills of articulation required by this approach. The dilemma that has arisen is that; although I feel that Wave 1 SEAL can make a significant contribution to the EHWB of children in mainstream education, Wave 2 SEAL is limited in tackling the emotional and social barriers of the students at Linhope.

Bearing this predicament in mind, it was encouraging to discover the then, recent developments in extended schools which included children’s services introducing new opportunities, “The opportunities come from better access to other services and a more clearly defined role in promoting children and young people’s wellbeing”.

In particular, the research review carried out by the C4EO (date) stated that in order to narrow the gap for CYP with additional needs, “services should both address the barriers to learning and support emotional resilience”. Interestingly, it states that there is evidence that some programmes and interventions have achieved positive outcomes for CYP with additional needs such as SEAL, full-service extended schools, multi-agency teams working with schools, alternative curriculum and using the common assessment framework (CAF) which, they say, can all address barriers to learning and help to improve emotional wellbeing.

They go further to cite good practice of CAMHS activities as the following:

The most common form of work was consultation and support to school staff, often on a case by case basis with children referred to their service. They also provided consultation on behaviour, training and supervision to school staff, and contributed to health promotion activities.

Unfortunately, was also cited and which reflects the true picture at Linhope is an actual weaknesses in access to CAMHS provision and long waiting times (around six months) for the CYP with both acute and moderate levels of need. Also evident, it appears are the capacity issues in relation to meeting mental health needs, and lack of clarity among partner agencies about the remit of the CAMHS and thresholds to access services.

At Linhope we follow rigorous identification and assessment practices. Referrals to the multi-professional team are made on a weekly basis. The predicament I find ourselves to be in is that although we have made great strides in identifying the needs of the CYP, responding to their needs goes beyond the educational and falls outside the traditional expertise of the teachers. What is also evident is that there is insufficient training and support provided for us to tackle these needs and inadequate provision of outside agencies and organisations such as CAMHS.

The Ofsted report – Narrowing the gap: the inspection of children’s services provides an overview of 102 councils to deliver services that improve the outcomes for children and young people. It highlights strengths and weaknesses in the contributions made by partnerships, making particular reference to each of the five Every Child Matters outcome areas.

In terms of the outcome “Being healthy” the report cited how the strengths of the higher performing councils had a:

Clear focus on health inequalities that ensures the needs of communities and vulnerable children and young people, such as those with emotional or learning difficulties, are effectively targeted…….. timely access to a range of services such as Child and Adolescent Mental Health Services (CAMHS), speech and language therapy, and physiotherapy….Well-developed CAMHS provision, with the necessary investment to provide speedy access to services to meet both acute and non-acute levels of need.

While at the same time, they cite the weakness of lower performing councils as:

Slow and inconsistent progress in tackling areas of weakness….weaknesses in access to CAMHS provision and long waiting times for young people with both acute and moderate levels of need,

This brings me to the last strategy, so far, in addressing the EHWB of the students at Linhope, providing an inclusive and supportive environment. I believe Maslow provides an excellent framework to help teachers focus on the needs of children who are with families ‘at risk’. Maslow has suggested a hierarchy of needs which drive behaviour. At the base of this hierarchy, he suggests are basic human needs, for example, the need for shelter, warmth, water and food. Once these basic needs are met we are able to focus on higher order needs such as love, friendship and respect. From experience I have witnessed how a deficiency in these needs can hinder a student’s performance at school. As can be imagined a student who has gone without breakfast or enough to drink or insufficient sleep the previous night will lack the energy to participate in activities and their attention may be split between focusing on school work and feeling hungry. Similarly, children with low blood sugar can become short tempered. Within the school environment we can be fairly certain that we can meet these basic physiological needs by providing breakfast, drinks, physical activity, offering ‘time out’, distracting activities, quiet places and even sleep. Once these needs have been addressed, the next level described by Maslow is safety and security needs. An educational psychologist working at Linhope explained how adults tend to only think of their safety needs in times of emergency because they are able to compartmentalise information. On the other hand, children often have a constant worry about their safety and security because they have not yet mastered this skill. For a child to feel safe and secure they need to know where they are going home to and to feel free from harm. For some children at Linhope, these needs cannot always be met. There have been occasions, for example, when children have shown distress because their family are being evicted that day, or their foster placement has broken down and they are going back into care or they have to move to a new family, or a parent has had a breakdown and can no longer cope. Sadly, such factors are beyond the control of the school environment. At best, in these situations, school staff can provide a supportive confidante, someone to talk to about the difficulties in the child’s life.

Once concerns for safety and security are met, the child’s needs are said to become more ‘internalised’. To a child, this is the need to be loved and to belong, not just in the family, but to other groups as well. For some, not all, the family can provide a child the unconditional love they need, while Linhope can offer opportunities to belong to a group or a team for example. At the fourth stage, the child is looking to fulfil esteem needs. At this level, the child not only wants to be part of a group but also to take pride in their accomplishments and to be recognised by others. If a student has reached this point at Linhope, then their Reintegration Readiness chart would indicate a need to return to mainstream education.

Finally, when all other needs have been satisfied, the quest for self-actualisation begins. Though Maslow’s theory suggests it would be impossible for a child to reach this level, I think children in general (although rarely at Linhope) can begin to seek self-fulfilment such as developing hobbies, volunteering in the community, involvement in clubs such as Duke of Edinburgh, pursuing accreditation or qualifications or working towards sports awards.

Conclusion

To summarise, theories provided by Goleman, Bandura, Dreikurs and Maslow have been beneficial in developing methods and practices to address the EHWB with CYP who have specific emotional, social and behavioural difficulties. In particular; using these methods and practices I have been able to find out the current levels, identify any gaps and ascertain the skills required to improve the EHWB of the CYP. The next step and which will be the focus for my Practise Based Enquiry is to try out more modern strategies and techniques. This will involve practical strategies for groups of children as was previously addressed by SEAL (Wave 2) and new one to one interventions which have not yet been a focus at Linhope (Wave 1).

Subsequent informative research, than those mentioned above, is proving useful in gaining further insight into methods and interventions to address the EHWB of the specific needs of our students. Beck (1979), Young (1990) and Sutherland (2002) have brought to my attention to the relationship of cognitive processes and emotional states. Beck and Young pay particular attention to core assumptions or ‘schema’, which are fairly fixed beliefs that are developed in childhood and which shape the child’s view of self, the world and the future. The explain that if the needs of the child are not properly met during childhood, for whatever reason, then the child could grow up with a distorted picture of reality and as such could lead to self-defeating patterns of behaviour during childhood and later in life. Based on these views, Sutherland in her book ‘strategies for changing behaviour, gives a practical interpretation to help CYP deal with problems associated with their EHWB. Importantly, I believe, it addresses one of the major issues for many children at Linhope; in that while the past can’t be changed the way we think about it can.

Finally, I firmly believe, schools can make a difference through what they do in their classroom. New integrated approaches described by integrated services sounds promising but have yet to demonstrate a major impact in terms of meeting the needs of the EHWB of vulnerable groups of CYPO. Linhope staff, including myself, do have the capacity and willingness to carry out new activities, even if it means operating in fields outside their traditional area of expertise. The major role, for me is to discover these new strategies and interventions and share any good practice with my colleagues.