From Research into Practice
The Powys’ Strategy, Outcomes,
Challenges and Lessons Learnt
Dr Sue Evans, Consultant Child Psychologist, Lead for
Parenting and Children’s Social Competence Programmes,
Powys Teaching Health Board
Jess Crumpton, Clinical Psychologist in Training
Powys – Mid Wales
Powys
Key Principles
 Multi Agency workforce Development and delivery
 Holistic and integrated interventions across child,
family, home and school
 Evidence based programmes/approaches at every
level
 Capacity Building and Empowerment for services
and individuals
Delivery
Model
Our Evidence Based Training Framework
Motivational
Interviewing
Remedy
Individual CBT
Restorative justice
Protection
IY Small
Group
Dina
Friends
Group/individual CBT
Motivational Interviewing
Prevention
Solihul programme
KIVa programme
Incredible Years® Programmes – parent, school.
child
Restorative
Justice/Approach
JAFF training incl information sharing
Pre school and
foundation phase
KS2
KS3 & 4
Supporting Fidelity with
IY Programmes
IY
Trainer/Mentor
Basic Parent, Baby, Teacher,
Dina , Home Coaching, ASD
Peer
Coach
Accredited
leaders
Accredited
leaders
Peer
Coach
Accredited
Leaders
Challenge
 How to provide an intervention for KS2 to promote
emotional health and well being which met key
principles:
• Complemented the IY programmes
• Could be rolled out to scale at low cost
• Had a strong evidence base, with scope for
building local evidence
• Multi Agency workforce Development and delivery
• Holistic and integrated interventions across child,
family, home and school
• Capacity Building and Empowering for staff
KiVa™ universal and indic
act
Presentation
graphics for student
lessons, for the
meeting of the
school staff, and for
the meetings with
parents
Highly visible
vests for
persons
supervising
recess time
Student lessons
and materials
involved
(teachers’ guides,
short films, and
other auxiliary
materials)
Online surveys with
feedback of progress
Monitoring implementation
and long-term effects
12
Preventive
Monitoring
Interventive
Antibullying computer
games
KiVa™ team
Clear guidelines for
tackling bullying
KiVa Anti- Bullying Programme in
Powys
13
•
A strategic decision to provide support for KiVa to be
rolled out county wide as a key strand in emotional
health and well being strategy: link with depression,
anxiety, motivation for school and learning
•
•
•
•
Training delivered through Powys THB with local trainer
Funding for training, materials and start up via CYPP
Delivered by schools as whole school approach
Parental involvement key (an important issue for
parents)
ITV News Presentation
http://www.itv.com/news/wales/2015-0512/anti-bullying-scheme-encouragesclassmates-to-speak-out/
Current Situation in Powys
•
•
•
•
•
•
15
44 Schools trained since 2014 (more than 50%)
13 are in third year of implementation
19 in second year of implementation
9 began implementation in September 2016
Capacity to train further schools by Summer 2017
On-going audit and evaluation involving clinical
psychology and educational psychology service
and the Clinical Psychology Department at Bangor
University
Powys Evaluation
Based on annual online survey
• 2,300 children at one year follow up
• 1,000 children at two year follow up
• Additional evaluation from survey of
school staff
16
18
Outcomes
School connectedness significantly
improved after two years of KiVa
Bullying significantly reduced after one
year of KiVa with further reductions
after two years
High levels of school satisfaction
Reflected in Estyn inspection reports
19
Challenge
How to fill the gap in effective post
diagnostic interventions for parents of
children with ASD?
• 5 groups since Jan 2017
IY ASD PROGRAMME: The Powys model
Local
accredited
Trainer
PTHB
Partnering in researchbuilding local evidence
base
Coordinated by
commissioned serviceAction for Children
IY ASD
Part of strategic post
diagnostic pathway
Strategic link with
new ND Service and
ISAP
Delivered by
Specialist
practitioners
Feedback from practitioners
working with IY ASD
Has enabled weekly contact with some families on our
caseload where contact may have only been monthly
Integrates into specialist practitioner role and
empowers parents to have successful interactions with
their children
Principles can be used with parents outside of the
group and are the foundation of 1to 1 therapy
Promotes a common foundation of skills for specialist
intervention to build upon
Intensive early intervention from specialist
practitioners
Parental Feedback
“ This course has been a lifesaver for us as a
family. The support from other parents has been
invaluable and the feelings that we are not alone
has been hugely supportive. Despite my initial
apprehensions the skills we are developing have
had an immediate impact on family life. We no
longer walk on eggshells and no longer feel as
though Autism dictates our lives. We feel so lucky
to have had this opportunity. Thank you”
lessons
 Don’t ‘train and hope’, build and fund a supportive
infrastructure
 Expect and plan for set backs e.g. change of
personnel, need for retraining
 Develop a strong business plan with multi- agency
strategic sign up
 Help the intervention speak for itself, encourage
cooperation between schools
 Develop local trainers to ensure low cost role out
 Plan for succession
®
YEARS
THE INCREDIBLE
OUTCOMES FOR POWYS
Jessica Crumpton
Trainee Clinical Psychologist
22nd March 2017
Overview
 Outcomes for 2016 to date
 Factors contributing to outcomes and
reflections
Outcomes
Groups, attendance, outcome measures
Groups
Delivered






12 Groups run
5 IY Basic
2 IY Toddler
3 IY Baby
2 IY ASD
IY School readiness
Engagement and
Retention
Total Attendance
Group Attendance
Demographics
 139 parents signed
up
 91% (123)
continued beyond
introductory
session
 Average group size
was 9
 32% from Flying
Start areas
 93% female, 7 %
male
*We know that parents start to make gain if they attend 50% or more of the programme, but make the most significant gains if
they attend 75% of more of the programme.
OUTCOME MEASURES
Health and Wellbeing
01 Mental
General Health Questionnaire (GHQ-30)
of problem behaviours
02 Measure
Eyberg Child Behaviour Inventory (ECBI)
Confidence
03 Parental
Karitane Parenting Confidence Scale
04
Text Title
Place your own text
here
Mental Health and
Wellbeing
Statistically significant
GHQ Mean Scores
6
Clinical cut off = 5
5
4
3
3.7
2
1.8
1
0
Pre
Post
Data available for 77
out of a possible 123
parents.
Measure of Problem
Behaviours: Number
Statistically significant
Mean Number of Problem Behaviours (ECBI)
14
12
12.5
Clinical cut off = 11
10
8
6
6.5
4
2
0
Pre
Post
Data available for 58
out of a possible 95
parents.
Measure of Problem
Behaviours: Frequency
Statistically significant
Mean Frequency of Problem Behaviours (ECBI)
144
132
120
108
96
84
72
60
48
36
24
12
0
Clinical cut off = 127
128.5
111.6
Pre
Post
Data available for 59
out of a possible 95
parents.
Parental Confidence
Mean Score of Parental Confidence
48
42
40.1
36
42.4
Clinical Cut off =
39
30
24
18
12
6
0
Pre
Post
Data available for 16
out of a possible 31
parents.
Qualitative Feedback from Parents
“It’s a lot better than I expected”
“Its given me confidence that I am
doing the right thing”
“It works”
“I can see the changes its made”
Reduction in parental report of number
and frequency of problem behaviours
Improvement in parental mental
health and wellbeing
Improvement in parental
confidence
Factors
contributing to
positive outcomes
Factors contributing to
positive outcomes
Frequency of trainings;
Action for Children;
Regular supervision and consultation;
Engagement of partner agencies.
THANK YOU FOR LISTENING.