1. Fostering Resilience: An Opportunity for Improving Outcomes
Mark Conway
Specialist CAMHS Team Manager

2. Opening Activity
What is resilience?

3. Academic resilience - definitions
Good educational outcomes despite adversity
We can spot the impact of academic resilience through individuals doing better than we might have expected
Promoting academic resilience will lead to better behaviour and results for disadvantaged pupils.

4. Why is it relevant for schools?
Resilience research has identified actions that can be taken to enable students to achieve good outcomes against the odds.
For schools, promoting it involves strategic planning and detailed practice involving the whole school community, to help vulnerable young people do better than their circumstances might have predicted.
Hart

5. Why Promote Resilience
33% will experience a separation parents (Faulkner, 2011)
25% experience bullying (Faulkner, 2011)
10% will have a diagnosable mental health illness (Faulkner, 2011)
25% of all children have emotional or mental health difficulties (DfE, 2014b)
Those with SEN 6X more likely to develop mental health difficulties (Emmerson and Hatton, 2007)
Nationally, around 18% have SEND (DfE, 2014b)

6. Why Collaborative Working is essential

7. Disease Burden Across Age
McGorry, 2007

8. Barriers CYP report Stigma Schools report similar frustrations
How do we talk to universal services?
Double stigma?
Safe environment to talk?
Schools report similar frustrations
Lack of resource
Lack of knowledge
Priorities?
Mind the Gap!

9. CAMHS and Schools Link Project Pilot

10. CAMHS and Schools Link Project Pilot
Commenced in January 2016
Joint funded by NHS England and DfE
Part of a National Pilot involving 22 areas
One of 10 Case Study Areas
Involves 10 Schools in the West of Somerset
3 Secondary Schools
4 Primary Schools
1 First School
1 Middle School
1 Upper School
Building upon current capacity

11. CAMHS and Schools Link Project Pilot
Emphasis on:
Clarifying roles, responsibilities and pathways
Offering bespoke training and development
Providing consultation
Promoting good mental health and early intervention
Speeding up access to advice and guidance
Promoting joined up practice and pooled resources
Challenging the “tiered approach”

12. Resilience in the Context of Risk

13. The Bio-Psycho-Social Model
Positive Biological Make-up
Positive Psychological Wellbeing
Positive Social Experiences
Resilient Child

15. Risk Factors
Protective Factors
Biological
Exposure to toxins (e.g., tobacco, alcohol in pregnancy)
Genetic tendency to psychiatric disorder
Head trauma
Hypoxia at birth and other complications
HIV Infection
Malnutrition
Substance abuse
Other illness
Age-appropriate physical development
Good physical health
Good intellectual functioning
Psychological
Learning disorders
Maladaptive personality traits
Sexual, physical, emotional abuse and neglect
Difficult temperament
Ability to learn from experiences
Good self-esteem
High level of problem-solving ability
Social skills

16. Risk Factors
Protective Factors
Social- Family
Social- School
Social- Community
Inconsistent Care giving
Family conflict
Poor family discipline
Poor family management
Death of a family member
Academic failure
Failure of schools to provide appropriate environment to support attendance and learning inadequate or inappropriate provision of education
Bullying
Lack of “community efficacy”
Community disorganisation
Discrimination and marginalisation
Exposure to violence
Lack of sense of “place”
Transitions
Family attachment
Opportunities for positive involvement in family
Rewards for involvement in family
Opportunities for involvement in school life
Positive reinforcement from academic achievement
Identity with school or need for educational attainment
Connections to community
Opportunities for leisure
Positive cultural experiences
Positive role models
Rewards for community involvement
Connection with community organisations

17. Likelihood of negative outcome
Risk and Outcomes
# Risk Factors
Likelihood of negative outcome
So what differentiates those who do well in adversity from those who struggle?
And
Can those who struggle in the context of risk be supported to achieve better outcomes?

18. What would we see in the emotionally resilient child?

19. The Emotionally Resilient Child
Knows they have someone close who loves them unconditionally
Will confide their thoughts and feelings in someone when needed
Is able to play or work independently
Has a positive outlook on life
Is willing to try new things
Likes to achieve things and receive praise
Likes themselves
Has confidence in their own abilities
Has a sense of humour
Has plans and ideas
Has people they know they can count on to help them
(Grotberg, 1997)

20. What Can Therapist’s in School do to foster/grow Resilience?
Schools as a universal context for young people.
Primary context outside of the home
Frontline-
Facilitate early identification of need
Provide opportunities for training and development
School based interventions
Need for common measures

21. What Can CAMHS Do to Support Resilience?
Primary Mental Health Link Support
Be present
Provide consultation
Early Intervention
Provide resources
Training and Development- Evidence-based
Partnership working

22. Which Way…

23. Not all interventions are equal
Moving and creating a new ethos can be challenging (Spoth et al. 2001; Sugai & Stephan 2013)
Continual Audit and Evaluation- not all interventions produce good results (Stallard et al. 2012)
Does not need to be expensive- In fact, it can be very economical:
Needs Championing
Strong leadership
CYP Involvement
Family Involvement (Whole School Community Approach)

24. Key Themes for the CYP
All approaches should have five key themes at their heart:
Promoting self-awareness
Developing confidence and self-esteem
Becoming self-reliant and independent
Recognising their own boundaries, strengths and limitations
Managing feelings
Learning to self-regulate
Becoming emotionally resilient
Being sensitive to the feelings of others
Developing a positive attitude
Building an effective learning style
Encouraging a questioning mind
Overcoming disappointments and setbacks with effective problem-solving
Facilitating empathy
Living and learning alongside others
Respecting difference and diversity
Showing appropriate care and concern for themselves and others
Building social skills
Developing positive peer relationships
Understanding social roles and rules
Knowing when and how to look for help

25. Key Strategic Themes
Whole school focus to build an agreed shared culture and identify that support emotional wellbeing.
Specific teaching of social and emotional skills
Booster intervention workshops for parents of children and young people
Working with parents to enhance parenting knowledge and capacity to support their child’s emotional wellbeing
Working with children in small groups to help build positive pro-social behaviours and strategies to enhance emotional regulation
To help generalise school and home learning, promoting positive problem-solving and strengthening emotional resilience
Holding regular ‘nurture’ groups for vulnerable people
Using play-based activities to build communication and relationship skills
Individual teaching to identified ‘at risk’ children
Building teacher skills in positive classroom management and organisation

26. What’s Next… The Schools Link Pilot will continue
Greater emphasis on role clarification
Increase awareness of the importance of resilience and early intervention
Workshops on ROMs
Provide training and consultation on resilience programmes for at least 2 of the schools
CYP Participation Group going into schools to challenge stigma
Schools to consider using CYP Champions
Potential expansion of pilot being considered
Establish group interventions in school
Additional Consultation with professionals offering 1:2:1 support.
County-wide Conference to be held