Children’s Fund Medway
Background
Mandy is a Year 2 child and has a medical condition which causes severe cyclical emotional difficulties for her. Such is the nature of her condition that her peers are beginning to notice differences in her appearance and as she gets older, the impact of these differences will become more apparent. Mandy is a friendly, quiet child who is very well supported at home by loving parents and a supportive older sibling. However, sometimes at home Mandy has emotional outbursts and when this happens the situation can cause some anxiety and tensions in the household, particularly for her sibling who tends to bear the brunt of her behaviour. Her parents feel that she has low self-esteem and she sometimes says that she is no good at anything. At school she is a friendly, caring and gentle child, an aspect which is not always fully appreciated by her peers. Her teacher felt that she sometimes seems sad. Her outbursts do not happen at school. Mandy is closely monitored by Great Ormond Street.
Approach
The parents had heard about Place2Be from other parents at the school. Great Ormond Street clinicians had suggested a referral to CAMHS but at this time the parents felt they would rather investigate Place2Be support for Mandy. The School Project Manager (SPM) carried out an assessment that involved speaking to the parents, child's teacher and Mandy. Initially, the SPM supported Mandy through 'extended P2Talk' until a place became available for a one-to-one intervention. A long term intervention began in October 2005 with a Place2Be volunteer counsellor. Weekly 50 minute sessions provide a supportive and safe space for Mandy, through a creative medium, to explore her feelings and to 'tell her story'.
Outcome
After a few weeks of Place2Be intervention, the feedback from Mum was that her child was so much happier, relaxed and things are a lot better for every-one at home. Further into the intervention, Mandy's mother said she felt this support gives Mandy 'the experience of being a little girl'. Her mother reports that since this support has been in place Mandy is much calmer at home and is really trying to work with her outbursts of temper, and confusion at the feelings she experiences. As a result of the changes the family have seen in the child, they have decided that for the time being the best support for the child is through Place2Be at the school as they feel it is more appropriate for her. Later, when she is a bit older they will take up the suggestion by the hospital that the child receives counselling from CAMHS, if they feel this is the right thing to do for their child.
Quotes
Mandy's Class Teacher reported that “Mandy smiles a lot now and is lots, lots happier now.”
Extract from letter written by Mandy's parent (full
letter available):
'She (Mandy) started at a school that didn't understand her so after a year
at that school we moved her to a new school with a 'Place2Be'. ..it has
helped her in so many ways. She loves going there which is what she needs as
she finds it very hard to mix with adults and children. It has also helped
her to understand herself a little and not feel that nobody will listen. It
has also helped us all at home providing support for all the family. The
staff are very nice and always have time for you. Hopefully, one day there
will be a 'Place2Be 'in every school for those children and parents that
need to be listened to'.
Estimated savings to statutory services as a result of intervention
It is possible that without the intervention of The Place2Be, this child may have needed a placement in a Pupil Referral Unit. According to a parliamentary answer, in the House of Commons on the 21st February 2005, the average cost of pupils attending a Pupil Referral Unit in England was £10,000 per year. (Hansard, 21.05.06: column 289w.)
Case Study 2
Background
Ben is not the child's real name.
In year 2, Ben had presented with challenging behaviour in class. With the transition to the Junior school, Ben’s behavioural difficulties in his year 3 class continued. He found it very difficult to sit still for even very short periods of time and was unresponsive to requests to settle down. Ben generally disrupted the class through his continual motion and lack of attention to tasks which affected his inability to achieve in his class work. Ben became more demanding of teacher and teaching assistant time and increasingly needed more one-to-one support as he was unable to respond to the instructions from his class teacher regarding the work to be done. When receiving 1:1 support in The Place2Be or in class, Ben presented as a friendly and likeable child, but when he needed to compete for attention, whether it was in the class situation or a small social skills group, he was unable to sit for a short time, to listen or be respectful to others. This behaviour reflected in his inability to make, or invite good friendships out in the playground. There is a history of loss in the family and it would seem that the trauma experienced by significant adults in his life has impacted on Ben. It appears that Ben is unable to process and make sense of adult pain and experience related to these past losses and this confusion may possibly have led, in part, to attachment and insecurity issues.
Approach
During year 2, Ben received support through a short term 1:1 Place2Be intervention and responded well to the one-to-one relationship with a Place2Be Volunteer Counsellor. Ben’s behaviour continued to be cause for concern when he joined year 3. During the school multi-agency meeting the SENCO (Special Education Needs Co-ordinator), the Place2Be SPM (School Project Manager) and Ben’s Class Teacher decided to refer Ben for a longer term Place2Be 1:1 intervention. Ben was supported for 4 terms (6 term year) through weekly 50minute sessions, initially with a Place2Be Volunteer Counsellor and subsequently with the SPM. Unfortunately, the Place2Be Volunteer Counsellor was unable to complete her year’s clinical placement due to ill health and the SPM continued supporting Ben during weekly 50 minute sessions. This work was significant and allowed Ben to explore his loss of the adult he had clearly formed a therapeutic relationship with and trusted, and who had now left. Ben worked through play and creative media, exploring feelings of sadness about this loss and other significant losses in his family. When this 1:1 intervention came to an end, Ben was included in a weekly Social Skills group supported by the SENCO and SPM working collaboratively. Towards the end of the year the SPM led a class Circle Time with Ben’s class.
Outcome
Ben responded well to the Place2Be 1:1 intervention with the VC and longer term with the SPM. He used the time very well to explore complex issues in his life and developed a trusting relationship with his counsellor. Ben’s class teacher and the SENCO both observed a difference in Ben’s behaviour and attitude. The teacher reported Ben was more settled in class and more able to concentrate on tasks set. The SPM and SENCO observed that he was able respond positively to being given small but responsible tasks to complete during the Social Skills group. Ben would also respond to praise in the small group and in Circle Time led by the SPM. Increasingly, with support from significant adults in school, including the SPM and SENCO, Ben was more able to acknowledge his own achievements and was less likely to behave in a way to gain negative attention. He became less restless and more settled in class and in the small group.
Because of complex family issues, the SENCO and the SPM felt that more support would be beneficial to this child and his family. A referral to CASTE, CAMHS Tier 2, was made for support during the summer break. The SPM and SENCO are monitoring Ben through regular reviews, as further support may be needed as he progresses further up the school.
Quotes
Following the intervention the HM spoke to the child's mother who wished her thoughts about the impact of the intervention to be recorded:
''P2B was a place where Ben was able to get away to, from the rest of the class, his time out. He was able to get away from the pressure of other children and school life and what's going on. It was a space for him to gather himself and calm down if he was feeling angry and upset. He said it was good and he felt happy going to P2B, it was time for him. The family were working on things at home and had also been supported by CASTE (CAMHS Tier 2 Service) in the home and P2B and this really has helped with his behaviour. I have told Ben that if he has a problem he could go and see X (P2B School Project Manager). P2B was always a place for him to go if was not able to talk to his teacher or anyone else. I told Ben he could talk about anything if he wanted to even if he couldn't talk to mummy about his worries. Ben is more confident about school now knowing that The Place2Be is there for him''
Estimated savings to statutory services as a result of intervention
Total cost to society of a permanent exclusion is £49,664 (Misspent Youth, New Philanthropy Capital, 2007)