Hampshire CAMHS developed an evidence based emotional wellbeing programme called The C.A.R.E. Programme. C.A.R.E. stands for; Coping And Resilience Education Programme. Designed for young people in years 4,5 and 6 of primary school, this is a brief three session emotional wellbeing (emotional literacy and emotional resilience) programme that can be delivered to individual children or whole classes
Hampshire CAMHS developed an evidence based emotional wellbeing programme called The C.A.R.E. Programme. C.A.R.E. stands for; Coping And Resilience Education Programme. Designed for young people in years 4,5 and 6 of primary school, this is a brief three session emotional wellbeing (emotional literacy and emotional resilience) programme that can be delivered to individual children or whole classes. The aims of the emotional wellbeing sessions are to: – Develop a child’s understanding of emotions and how to communicate and express themselves emotionally – Develop and enhance a child’s emotional resilience by providing techniques and strategies to help them to cope with emotions such as anxiety, sadness and anger. – Improve confidence in children asking for help if they are struggling emotionally and to educate children in how and where to access support if necessary. The format includes, three one hour sessions delivered in three consecutive weeks. Following the three session programme, a session for parents and carers of young people that have participated is facilitated. This provides an opportunity to share a summary of the programme content, to provide feedback about the outcomes of the programme, to answer any questions parents/ carers might have and to provide some psychoeducation around child mental health along with information provision about CAMHS and other resources available to young people, parents, carers and schools. Below is a brief synopsis of what is covered in each of the three sessions. All sessions are experiential, with exercises, activities and demonstrations to facilitate learning and engagement. A beautifully designed and illustrated booklet of all the strategies and techniques taught in the C.A.R.E. programme is given to each child participating. Within this is also information for parents/ carers about where to gather more information, support or advice for a child’s mental and emotional health and what to do if they are concerned.
Session 1 – Introduction to the C.A.R.E. programme & what we’re going to be doing – Identification and exploration of different emotions with particular focus on sadness, worry and anger – Introduction to self-soothing and coping techniques including mindfulness Session 2 – Making links between thoughts, emotions , physical sensations and behaviour – Focus upon physical sensations as an early warning indicator of distress – Exploration of current resources and coping strategies – Teaching of new coping strategies (including grounding, muscle relaxation, distraction and guided visualisation) Session 3 – Learning about difference and embracing unique qualities in order to boost self-esteem – Emphasis on values; identification of the values that are important to those participating – Learning about how and where to access help and support if struggling to cope – Recap of emotional coping strategies and material covered in previous sessions to consolidate learning of previous material – Finish with a celebratory certificate presentation to all those who participated Initially, CAMHS clinicians delivered the C.A.R.E. programme directly to schools, however to maximise the number of schools and therefore children that would benefit from this programme, a collaboration was formed with Hampshire School Nursing Team. A senior Clinical Psychologist provided in vivo training, support and supervision to a number of school nurses who then facilitated the programme to the schools they were assigned to. To date; 763 young people from across 15 different schools have formally participated and completed the C.A.R.E. programme. This does not include the hundreds of others who will have received the programme delivered by teaching staff at the schools that originally participated who learnt the skills and techniques.
Wider Active Support
Strong collaborations were made with primary schools up across Hampshire in order to gather support and consent for delivery of the programme. Furthermore, in wanting to think about sustainability of the programme and maximise outreach, a strategic management agreement was made with Hampshire School Nursing Team about a training and delivery model in which Hampshire CAMHS provided training, support and supervision of school nurses who then delivered the programme within schools. This was further extended to ELSA’s and SENCO’s within schools.
Co-Production
Part of evaluation and audit of the programme involved collecting both qualitative and quantitative feedback from young people. This feedback was used to inform redesigns of materials used and the content of sessions. An example of this includes; The Wheel of Emotions; a practical resource for an exercise around emotional literacy. A brightly coloured engaging board with a spinning wheel which depicts different emotions, with different synonyms plus an emoji pic correlating to the emotion on each segment. Young people helped identify the most common synonyms for the key emotions depicted (e.g., sad, worry, angry, happy, calm) along with the colour segments. Based on young people’s feedback, we collated ideas about how to make some of the exercises and resources more appealing and gender neutral; such as having different prototypes of coping boxes to illustrate what could be included to appeal to different individuals.
Looking Back/Challenges Faced
Rolling out this programme across Hampshire has been a challenge. Hampshire CAMHS is a busy service with limited resources dedicated to the implementation of innovation base early intervention/ health prevention/ promotion campaigns. With only a small amount of dedicated time from a senior clinical psychologist, assistant psychologists, primary mental health workers and other mental health practitioners, the programme was delivered to a number of schools across Hampshire as a pilot. Following the evaluation and subjective and objective success of the pilot, a strategic management agreement was sought between Hampshire CAMHS and the Hampshire School Nursing Team to train and supervise Hampshire School Nurses to deliver this programme therefore allowing the programme to be more widely disseminated.
Sustainability
Following the evaluation and subjective and objective success of the pilot, a strategic management agreement was sought between Hampshire CAMHS and the Hampshire School Nursing Team to train and supervise Hampshire School Nurses to deliver this programme therefore allowing the programme to be more widely disseminated. This has further been extended to include training and supervising some ELSA’s and SENCO’s within schools so they can deliver the programme to their schools under the supervision and support of CAMHS.
Evaluation (Peer or Academic)
The programme is evaluated by a number of measures including; 1) A before and after session ‘emotion thermometer’ to capture how young people are feeling at the start and end of each session. This is a subjective rating scale from 0-10 (calm through to worried/ sad/ angry). 2) A post session IAPT group evaluation measures which consists of 4 subjectively rated Likert scales. Questions asked included: How much the young person felt the group leader listened to them How important the topics covered were to the young person How much the young person liked what was done in the session How much the young person felt part of the group This measure was completed at the end of each of the three sessions with all young people that participated. Young people were also asked to write down one thing they would take away from the session and any suggestions for recommendations, changes or improvements. 3) A brief subjective questionnaire both prior to the first session and following the final session which helped to evaluate whether the aims of the project had been met.
Three Likert Style questions were asked which centred upon; awareness of emotions/ how to look after oneself emotionally (Q1), confidence in managing emotional difficulties (Q2) and knowledge of where/ how to access help for difficulties (Q3). Young people were required to indicate how much they agreed with statements on a scale of 0 to 5, whereby 0 out of 5 indicated no awareness/ confidence or knowledge and 5 indicated full awareness, confidence and awareness. At the end of the programme, young people and teaching staff from school who had been present throughout delivery of the programme were asked for their subjective qualitative feedback about the programme. Parents of children who had participated were invited to a parent feedback session during which time, outcomes where presented to parents and parents had an opportunity to provide feedback about their observations or views about the programme. A six month follow up survey has been developed for schools to complete in order to establish longer term outcomes of the programme.
Outcomes
To date; 763 young people from across 15 different schools have formally participated and completed the C.A.R.E. programme. This does not include the hundreds of others who will have received the programme delivered by teaching staff at the schools that originally participated who learnt the skills and techniques. Overall, every school showing improvements in young people’s understanding/ awareness of their emotions/ how to look after oneself emotionally, confidence in managing emotional difficulties and knowledge of where and how to access help for difficulties being experienced. Some of the qualitative feedback and comment from young people, parents and teachers included: “The course is really helpful and absolutely amazing” “It’s been great. It has helped me in school a lot” “The children grew in confidence week on week. They all took part in the exercises and engaged well with the material covered. The children became notably more emotionally literate (i.e., more able to express and communicate their emotions and emotional needs)” “The material covered was important. It covered a breadth of topics and was delivered in an age appropriate way with creative approaches for including and engaging all children.
We were pleased with how the programme was delivered and the outcomes obtained” “The things I loved about this include everyone, fun and entertaining, friendly, all of it! Things I would change, make it longer because I love it!” “These are vital skills and I’m very glad my child has been a part of this programme” “It’s provided useful ideas of strategies that can help my child both now and in the future” “The CARE programme provides such useful information. Our children have really benefitted.” “It has provided our children with both the permission to express their feelings and the language to communicate how there are feeling” “The techniques taught were fun, engaging and creative” “I have noticed the positives already- that my child is more confident” “The children have all enjoyed the CARE programme and all been able to engaged and take part in their own way” It is difficult to collate all the data in a meaningful and helpful way for purpose of this nomination but we would be happy to share the outcome reports if this would be helpful. Please contact Emily David (Emily.David@nhs.net) if you would like outcome reports.
Sharing
Here at Hampshire CAMHS we are very keen that as many children and young people as possible have access to the resources, skills and information that will benefit their health and wellbeing. Any school in Hampshire, state or private are able to request the CARE programme. We are also keen to share the programme format, content and resources with others who may want to replicate the programme in a different area, with support and guidance from our team.
Is there any other information you would like to add?
If you would like to see copies of the outcome reports or indeed any of the resources and materials that are sent to parents/ carers and given to young people, such as the booklet of resources and information, please email Emily David (Emily.David@nhs.net)
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