DISCOVER Workshop Programme for Care Experienced young people
Research type
Research Study
Full title
DISCOVER "Getting the Life You Want" Workshop Programme for Care Experienced young people aged 16-19: A feasibility and acceptability pilot study
IRAS ID
303093
Contact name
Irene Sclare
Contact email
Sponsor organisation
South London and Maudsley NHS Foundation Trust
Clinicaltrials.gov Identifier
Duration of Study in the UK
0 years, 8 months, 30 days
Research summary
RESEARCH QUESTION:
This research is designed to develop and test a new mental health and emotional well-being intervention for Care Experienced young people (CE YP) aged 16-19. We will explore the intervention’s feasibility, accessibility and acceptability as well as early-stage outcome data.BACKGROUND ("WHY?"):
• Statistics for CE YP mental health, emotional well-being and life chances are shocking and historically they are under-supported with the transition out of Care.
• ~45% of Looked After young people aged 5-17yrs meet criteria for a diagnosable mental health condition (compared with 13% of peers in the general population; Department of Health, 2015)."WHAT?"
The DISCOVER team has secured 2-year funding from the Maudsley Charity to tailor the workshop programme we deliver in Sixth Forms to meet the specific needs of CE YP. We are planning to complete a pilot of this adapted workshop programme within Medway Children's Social Services.
"WHO?" & "WHERE?"
We will recruit CE YP who are known to the Care Leavers 16+ teams within Medway Children's Social Care. The study will be conducted at Medway Local Authority sites (e.g. the main group room in the office building for the Care Leavers 16+ teams and - if needed - at young people's semi-independent accommodation), with some stages being completed remotely via Microsoft Teams if needed in the context of the ongoing COVID-19 pandemic.
"HOW?"
The study will last up to 12 months- allowing for recruitment, workshop programme delivery and follow-up for up to 40 young people.
The programme stages include: 1:1 meeting with a Clinical Psychologist, one-day workshop, optional support phonecalls, and a follow-up 1:1 meeting with a Clinical Psychologist (2-3 months post-workshop). Self-report measures will be used to gather data on young people's difficulties and strengths in the pre- and post-workshop 1:1 meetings to track any changes. We will also gather their feedback about the programme's feasibility, accessibility and acceptability.
LAY SUMMARY OF RESULTS:
"UPTAKE OF THE DISCOVER ""GETTING THE LIFE YOU WANT"" WORKSHOP PROGRAMME & PARTICIPANT DEMOGRAPHICS
* Through our partnership with the Medway Care Leavers 16+ service, 10 Care Experienced young people aged 16-19 signed up to take part in the DISCOVER GtLYW programme and attended an initial 1:1 psychology assessment with a Clinical Psychologist from our team.
* 90% of the sample were presenting with emotional difficulties significantly above clinical threshold for anxiety and/or depression during their first DISCOVER meeting.
* 80% of the young people required a mental health risk assessment, given concerns that were identified during their first DISCOVER meeting.
* All 10 young people had accessed mental health support from their local CAMHS service in the past, with only two (20%) who were currently accessing this at the point of starting the DISCOVER programme. Three of the young people had also accessed some form of 1:1 counselling, either through school or through a non-CAMHS community-based organisation.
* The young people who took part represent a range of experiences of CAMHS:Â three (30%) described their historical/current experience of CAMHS support as helpful, with a further young person saying that she had valued the space to talk with a professional in the past, but this was undermined when sessions were forced to be online due to the pandemic.
The remaining six young people (60%) reported that they did not find CAMHS support to be helpful. Three of these six young people had been left feeling uncertain about who had been working with them and what they had been working on together, while the other three shared that they had found CAMHS support to be actively unhelpful.
* The latter group said that this negative experience was due to; the support not being tailored to them, feeling they had clashed with their therapist / been misunderstood and the view that they had felt worse in themselves after every session.SUMMARY OF STUDY RESULTS
1) QUANTITATIVE:
Young people who attended were asked to provide anonymised feedback at the end of their DISCOVER workshop day by completing an anonymous feedback questionnaire. The results were as follows:
100% rated the quality of the DISCOVER service as excellent OR good.
100% were satisfied with the DISCOVER service.
100% felt that they got the help they wanted.
100% rated that all or most of their needs had been met.
100% would recommend the workshop to a friend.On average, when young people's questionnaire scores from before the workshop programme were compared with their scores from the post-workshop meeting 2 months later, there was a:
Reduction in low mood symptoms (not statistically significant).
Statistically significant reduction in anxiety symptoms.
Statistically significant improvement in their mindfulness score.
Improvement in wellbeing and resilience (not statistically significant).2) QUALITATIVE
Medway Care Leaver service staff were invited to take part in a semi-structured interview to explore their perspectives on how best to support the mental health of Care Experienced young people on general, as well as the DISCOVER workshop programme, specifically. Interview transcripts were analysed by our research group used a method called ""Interpretive Phenomenological Analysis (IPA)"". Taken together, the staff interview data indicate that, to overcome potential access barriers and support more Care Experienced young people in their emotional wellbeing, intervention design and delivery must be sensitive to the following considerations:
The extent to which each young person is ready to engage.
The importance of NHS clinicians building trusting relationships with young people.
The negative preconceptions that stakeholder groups may have about NHS therapeutic support, that must be dispelled if the intervention is to be effective.
The wider support networks around CE YP and how best to involve them.
The many factors that can underpin or threaten intervention accessibility for young people; ranging from transport to and from the host community space, to how far Children’s Social Care staff understand the DISCOVER intervention as grassroots champions for the referral and delivery processes.
YP and staff valued specific (e.g. goal-directed skill-building support) as well as non-specific aspects (e.g. a consistent approach and creating an emotional safe space for YP) of DISCOVER the intervention.
Standardised outcome measures are one way to capture the impact of an intervention on Care Experienced young people, with feedback from trusted adults who know them best as another valuable way to track this impact. The allocated Medway staff picked up on shifts in body language, increased openness in communication, and new routines of positive skill-focused habits as evidence that their young people had benefitted from the support offered."REC name
West Midlands - Coventry & Warwickshire Research Ethics Committee
REC reference
22/WM/0004
Date of REC Opinion
3 Mar 2022
REC opinion
Further Information Favourable Opinion