The Resilience Passport – Bradford District Care NHS Foundation Trust – Winners #CYPMHAwards19 and HC #MHAwards19

The Resilience Passport (RP) is a child-friendly and fun mental health promotion and training programme. It contains a number of tools and tips to develop emotional and physical resilience in children in primary school preparing for SATS. Children explore how they feel using a wellbeing battery concept and think about what support they need to feel ‘fully charged’, for example how others can affect their battery level, how they can charge their own batteries and what they can do to charge other people’s batteries. Children record feelings, thoughts and emotions in their own colourful ‘passport’ which they work through in classwork.

Winners #CYPMHAwards19 and HC #MHAwards19

Co-Production

  • From start: Yes
  • During process: Yes
  • In evaluation: Yes

Evaluation

  • Peer: Yes
  • Academic: No
  • PP Collaborative: Yes

Find out more

What We Did

The Resilience Passport (RP) is a child-friendly and fun mental health promotion and training programme. It contains a number of tools and tips to develop emotional and physical resilience in children in primary school preparing for SATS. Children explore how they feel using a wellbeing battery concept and think about what support they need to feel ‘fully charged’, for example how others can affect their battery level, how they can charge their own batteries and what they can do to charge other people’s batteries. Children record feelings, thoughts and emotions in their own colourful ‘passport’ which they work through in classwork.

The Resilience Passport is designed for use within the Personal, Social, Health and Economic (PSHE) education curriculum where pupils develop the knowledge, skills and attributes they need to manage their lives now and in the future. The programme is underpinned by an innovative and successful whole systems resilience framework called ENGAGE Together protecting well-being, promoting relationships and supporting targeted approaches. ENGAGE is an acronym where each letter represents an action that will charge the child’s well-being battery: E= emotional support/empathy, N=natural effection, G=give time, A=Affirmation, G=good deeds and E=enthusiasm. To equip the Year 5 teacher (known as the Passport Controller) to successfully deliver the RP programme and maximise benefits to pupils, learning takes place with the CAMHS Trainer/Facilitator. All the learning is underpinned by the evidence base around attachment, therapeutic relationships and the cognitive behavioural approaches. Additional health promotion resources are included as part of a ‘Travel Pack’ to support the outcomes of helpful communication, early acknowledgement and identification of the needs for additional support, self-care and pro-social behaviour. The Resilience Passport is a new resource and was piloted from February to June 2018 with Y5 pupils in a local school. The pilot was evaluated to assess how successful the passport had been to emotionally prepare children for SATS (see later questions). Our intention is to promote further marketing of the passport.

 

Wider Active Support

The Resilience Passport has been created by BDCFT’s CAMHS Trainer/Facilitator who provides the multi-agency sector in Bradford District with education and learning to combat the stigma around mental health, promote emotional intelligence and support recovery with a whole systems approach. The CAMHS Trainer/Facilitator utilised existing relationships and establish new alliances to gain encouragement, backing and assistance to make the Resilience Passport a successful tool. Within BDCFT there has been involvement from: • BDCFT staff suggestion programme (iCare) – support with planning, developing, piloting, evaluating the passport and future marketing/promotion. • Business support – project management advice and expertise and data analysis. • Communications – advice and guidance on age-appropriate style and design of the passport. • School Nursing Teams and CAMHS Primary Mental Health Workers in schools – support for the passport and it’s usage. Key external partnerships utilised by CAMHS Trainer/Facilitator to raise awareness of the key objectives and impact of the project on the well-being of pupils are: • Mental Health Champions in Schools Network Meetings • Member of the multi-agency Future in Mind (FiM) Project Delivery Group and contribution to the FiM refresh (lead on the Workforce Development workstream). Partners include Youth In Mind (Buddies, Yorkshire Mentoring, Sharing Voices Bradford, Barnardos WRAP and Young People’s Safer Spaces), Public Health, Voluntary and Community Services (Third Sector). • Collaborated on a bid by a local VCS organisation to develop the infrastructure to deliver transition workshops in schools.

Co-Production

During the development of the Resilience Passport resource, young people from Barnardo’s Senior Participation Group and BDCFT’s Young Dynamos (a young person’s research group) were consulted for their views and suggestions in terms of design, content and implementation of the ENGAGE Together model and the Resilience Passport. The CAMHS Trainer/Facilitator worked with colleagues leading both projects to communicate with the young people. Consultation with the Barnardos young people’s participation group was undertaken in two workshops where feedback was provided on key aspects of the ENGAGE campaign. Young people told us that they liked the concept of well-being batteries and liked the link with the concept of charging a mobile phone using words such as ‘boosting’, ‘recharging’, ‘energising’, ‘filling up’, ‘topping up’ and giving life. As a result the well-being batteries became associated with being charged like a mobile phone in their conceptualisation.

The CAMHS Trainer/facilitator attended The Young Dynamos meeting where they discussed the ENGAGE campaign ideas. They felt that the model could do more to encourage children to think about their responsibility to consider the needs of others as well as their own needs. This feedback was key to the development of the three ENGAGE Together ‘Territories’ whereby in territory 1 other people charge their batteries, in territory 2 they charge their own batteries and territory 3 they charge other people’s batteries. The Young Dynamos also commented that charging well-being batteries should not have a cost attached because it would exclude poor families. This feedback contributed to the G=good deeds well-being battery. The illustration below shows how young people influenced the ENGAGE acronym. Original ENGAGE acronym: Empathy Nice nudge Give surprises Affirmation Good deed Exclusive time ENGAGE acronym which was adopted following suggestions from the senior young people’s participation group at Barnardos: Emotional support/empathy Natural affection Giving time Affirmation Good deed Enthusiasm Prior to starting the pilot views were sought from Year 5 pupils on the overall look and feel of the passport. Pupil’s told us that they liked the design, particularly the motivational quotes which include Winnie the Pooh. This feedback was used to inform the user guide, training and the final version of the passport for use in the pilot. During implementation, the pupils were asked what they liked best about the resource and what could be better. Whilst most said it didn’t need improvement, a common request was for more pages in the passport. A key favourite was the use of drama to practice helpful communication and asking for help. Feedback from pupils after their learning was completed demonstrated that the Project has achieved its pupil objectives; one typical comment was “I now feel better about SATS and other tests I do.”

 

Looking Back/Challenges Faced

Having undertaken an Award in Education and Training the CAMHS Trainer/facilitator will use the lesson planning format to train teachers in using the resource for each phase of teaching/ implementation. The CAMHS Trainer/facilitator overcame the challenge of communication with a busy school by developing a helpful and positive relationship with the school. For e.g. providing the text for communication with parents which made the process easier for the school.

Sustainability

We are keen that the Resilience Passport model becomes a continuous cycle in the school year, therefore part of our ongoing development work will involve a train the trainers model for implementation in schools and a range of online resources including training materials/handouts, information to support teaching sessions, helpful reading, activities. Ultimately, we see the project supporting young people to develop their leadership skills by being involved in key aspects of the project delivery e.g. resource development, research and training. Young Dynamos and Youthwork Apprentices can develop their skills and competencies and can be involved in sustaining emotional resilience.

 

Evaluation (Peer or Academic)

A pilot of the Resilience Passport was undertaken during February and October 2018 with Year 5 pupils in a local school to determine the resources user-friendliness and ability to achieve its emotional resilience building and well-being management objectives. Ultimately, we wanted to gauge what impact the Resilience Passport had on the children’s emotional preparedness as they approached SATS in Year 6. Results from the evaluation of the pilot confirm that the Resilience Passport builds resilience and prepares pupils for the emotional journey to SATS. Both the pilot and the tool itself were successful in achieving their objectives and demonstrating how usable and effective the passport is in practice. Key findings Pupils in year 5 used their Resilience Passports to visit three well-being Territories with their Passport Controller (PC) teacher. They learned how by working together with their peers and others, they could undertake Activities of Battery Charging (ABCs) for their 6 well-being batteries that spell the word ENGAGE. with each letter representing an action that will charge the child/young persons’ well-being battery. E = Emotional Support/Empathy, N = Natural Affection, G = Give Time, A = Affirmation, G = Good Deed and E = Enthusiasm. Emotional readiness for SATS An overwhelming majority – 95% of the pupils reported that they were better at managing their well-being around SATS than before they took part in the RP Pilot. 70.8% gave a very happy smiley face response to the statement about being better at knowing what charges their ENGAGE well-being batteries. Emotional literacy 100% of pupils were able to identify what charges their well-being batteries and could name the feelings associated with their battery charge level; a vital pre-cursor to managing their emotional well-being during the emotionally turbulent journey to SATS.

Resilience in each well-being Territory At the end of their visit to each Territory, most pupils recorded well-being battery charge levels that remained fully charged or running low; demonstrating the stabilising impact of the RP on emotional well-being. The majority of well-being battery charge changes were from running low to fully charged which is evidence of the RP impact on well-being management and improvement. Me from Others Territory Of the pupils who experienced no change in battery charge level (38.5%), most stayed at level 3 (fully charged). The Resilience Passport was instrumental in showing pupils what being okay looks like; their battery charging activity is working for them and/or they might need do ABCs to boost their well-being batteries. For pupils whose battery charge levels reduced, they received the evidence-based, anti-stigma RP learning that all pupils received around emotional literacy, asking for help and self-care. One child stayed at 1 and as the User Guide directed, received the necessary support pointing to effectiveness of the early mental help features of Resilience Passport in helping pupils notice when they might need additional support. Helpful communication of well-being needs 84% of pupils reported being better at helpfully communicating their well-being battery needs than they were before they started using their Resilience Passports. The RP Visa data recording is successful in early identification and support for pupils who may be struggling to communicate their well-being needs have their batteries charged by others. Me from Me Territory 42.3% of pupils recorded an increase in their Affirmation well-being battery charge in this Territory, a large proportion of which was from 2 to 3. There was no change in this battery charge from 3 or 2 for most of the remaining pupils. This result showed the benefits of RP ABCs that focus on promoting a positive self-image. Emotional self-care 87% of pupils reported being better at charging their own well-being batteries after their RP learning and practice.

Others from Me 96% of pupils of pupils believed that their actions of Natural Affection towards others close to them contributed to others feeling comfortable and safe which resulted in charging the pupils own well-being battery in this Territory. 53.8% saw an increase in their Affirmation well-being battery as a result of charging the Affirmation well-being batteries of others in this Territory. Most of the increase was typically from level 2 to 3. This was a pleasant result to observe as it recognises that pupils were able to demonstrate actions and words designed to make others feel good about themselves. Pro-social behaviour 92% of the year 5 pupils taking part in the pilot considered themselves better at charging other people’s batteries Using the Resilience Passport When asked directly about their experience of using the RP, the pupils reported enjoying having and using their very own passports and Visas to rate the charge on each of their six well-being batteries. They particularly enjoyed using drama to explore choosing helpful ABCs – activities to maintain and boost their well-being batteries – many of which they hadn’t thought about using before they started using their Passport. Feedback from Passport Controller (Teacher) Pupil engagement Pupils were engaged with the RP learning from start to finish around emotional literacy, asking for help and self-care. They understood the concepts of resilience, well-being batteries and Well-being Territories. Visas and pupil self-assessment Pupils enthusiastically embraced self-reflection using their Visas to explore their well-being battery charge and feelings.

This demonstrates the usability of the RP resource and the importance of the Visa to helping pupils develop useful life skill habits. Early identification and support Pupils who needed it were good at taking up the offer of taking time-out where they chose not to be involved in an activity. Pupils were also offered the chance to talk using existing processes for providing pupils with additional emotional support if they were struggling with any aspect of their journey. This result showed the RP tool can help to identify early where a pupil might need help with communication, self-care or pro-social behaviour. Emotional self-care Pupils appeared to gain a great deal of benefit from being kind to themselves and exploring how they can charge their own well-being batteries Emotional literacy Pupils began using only the ‘happy’ or ‘sad’ feelings words and progressed through the Territories to using the other words to describe their battery charge levels showing evidence of a gradual increase in emotional literacy Helpful communication Pupils enjoyed using the ‘assertive, passive and aggressive’ communication resources with drama and gained vital communication skills needed for getting the help from others to charge their well-being batteries e.g. talking to their parents.

 

Outcomes

The Resilience Passport is a newly developed resource and therefore it is difficult to assess the impact on improved outcomes for children and young people. However, Bradford has the third largest child population in England and adverse childhood experiences that post a risk to mental health are a reality for many. The rate of demand for specialist child and adolescent mental health services is set to exceed the expected rise in the child population. Additional challenges to emotional well-being like SATS make it important to develop the resilience of the Year 5 group of children whose journey through life can post many challenges. By promoting helpful communication, emotional self-care and supportive relationships, the Resilience Passport has the potential to stem the tide of children and young people requiring specialist interventions and risk support.

 

Sharing

Our CAMHS Trainer/Facilitator is passionate about the Resilience Passport and throughout its development and implementation has been proactive and enthusiastic about sharing the work. This has included: • exhibiting at numerous Trust events, for example our Research and Development multi-agency conference. • delivering a poster presentation at BDCFT’s iCare innovation event. • promoting the tool at multi-agency forums, such as Youth in Mind (an integrated, community-based mental health service for children and young people in Bradford, Airedale, Wharfedale and Craven). • regular communication with teachers

Is there any other information you would like to add?

We are pleased with the initial evaluation of the Resilience Passport and see it as a resource which could apply to many age-groups not just those associated with SATS. In particular we are keen to consider how the passport can support emotional resilience in the transition from primary to secondary school.

 

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