Measuring successful outcomes
The children referred to the BIS programme have complex social and emotional needs. We adopt a child-centred approach to look at the needs of each individual child and develop a package of support depending on their needs.
When working with emotionally vulnerable children, the first priority is to prevent mental health from getting worse and to stabilise the child’s situation. This is seen as a good baseline outcome. Then one or more of the following must be met to indicate improvement:
- Emotional well-being of the child/young person has improved
- Incidence of diagnosable mental health issues have reduced
- Links to academic improvements have been demonstrated
Our services are evaluated using a mix of standard SDQ, CORS and CGAS questionnaires, and a bespoke school-based questionnaire. Where possible, we collect evaluation from the child, parent and teacher, to get an in-depth picture of a child’s progress. In addition, we collect qualitative data to complement and test the standardised scoring.
Strengths and Difficulties Questionnaire (SDQ)
These are generic forms recognised by Child and Adolescent Mental Health Services (CAMHS). 50% improvement is judged a good outcome by CAMHS and other professional services, funders, the government, researchers and educationalists. The SDQ is a broad measure of child mental wellbeing that is used extensively in clinical work to monitor outcomes in children.
Completed by school staff and/or the parent, SDQ questions are broken down into five categories:
- Emotional symptoms
- Conduct problems
- Pro social
- Peer relationships
Child Outcome Rating Scale (CORS)
These are clinically validated measures of four dimensions of child functioning that are widely considered to be valid indicators of successful outcome. The forms are completed by the child to capture how their social and emotional difficulties have been helped, in these areas:
- Personal distress
- Social role
- Interpersonal wellbeing
- Overall wellbeing
The Children’s Global Assessment Scale (CGAS), adapted from the Global Assessment Scale for adults,) is a rating of functioning aimed at children and young people aged 6-17 years old. The child or young person is given a single score between 1 and 100, based on a clinician’s assessment of a range of aspects related to a child’s psychological and social functioning. The score will put them in one of ten categories that range from ‘extremely impaired’ (1-10) to ‘doing very well’ (91-100).
School based Questionnaire
These bespoke questionnaires collect information from the child’s teacher to measure the child’s capacity to engage in learning, manage themselves in the classroom, settle to task, relate to others appropriately, regulate feelings and accept help.
Quantitative data does not stand alone: qualitative data is often required to understand what the figures are showing. Extended reviews with children, parents and teachers are part of the therapeutic process and also help us test the scoring and understand discrepancies.
For instance, one child at risk of exclusion ended therapy with no apparent change in her score. But in discussion it emerged that she had been helped to hold on to her place in school through a very difficult period of family illness and change: an excellent baseline outcome.
Another withdrawn child had become more in touch with her feelings through the therapy, including the times she felt angry and sad. This appeared as a negative score on her ending questionnaires. On the other hand, the discussion with her parents and teachers revealed that she had become more independent, less nervous in class, and was spending more time with friends: healthy outcomes for a child whose isolation and anxiety had been causing serious concern.
The Bridge Foundation is a Member of the area I-Thrive Operational Group, part of a national programme of innovation and improvement in child and adolescent mental health. We are also an Associate Member of CORC, the Child Outcomes Research Consortium, which leads on tools for an evidence base to improve children and young people’s mental health nationally. We raise awareness of the mental health needs of children on radio and through journal articles, and feed into parliamentary inquiries. On a local level we maintain close relationships with local commissioners, sharing the findings of our work with them, to inform policy making and funding decisions.
In our most recent evaluation we worked with 24 schools with a combined population of over 10,500 benefitting from the work. We delivered 1,525 sessions and worked with 152 children and families. We also delivered specialist sessions to parents and directly supported school staff.