1. CORC for Schools Schools in Mind Breakfast Briefing Tuesday 8 th March 2016 Emma Morgan

2. CORC for Schools 1.Overview of CORC for Schools 2.Introduction to the measures that are proving popular and practice at scoring one 3.Benefits and challenges arising from the pilot: consulting on attainment measures 4.CORC for Schools membership models and training offer

3. 1. Overview of CORC for Schools

4. Who are CORC? Child Outcomes Research Consortium Grass roots not-for-profit learning collaboration Founded 2002 by mental health practitioners and service managers Over half UK CAMHS are members + parts of Scandinavia and Australia Links to UCL/Anna Freud Centre CAMHS Evidence Based Practice Unit Current strategy sees a move into a greater number of voluntary and education sector spheres

5. CORC’s Mission To support all those seeking to provide services that promote child wellbeing to make meaningful use of outcome data to develop highest quality services As part of person centred care To improve direct work To inform the improvement and design of services

6. The CORC for Schools Pilot an initial set up conversation about the nature of participant interventions; advice about suitable outcome measures; ongoing support in their use – availability by phone and email; optional training on the measures; a method of flowing data to us, and help in its set up; merging of (already pseudonymised) education data and health data at this end; a final bespoke report tailored to their requirements. Types of school Mainstream secondary Mainstream primary AP Secondary AP middle AP primary Special school 4-19

7. What schools have valued most Initial attraction: demonstrate impact Personal advice and support Low cost (in this case, free) Low admin burden – help with data flow Sharing best practice

8. 2. Introduction to the measures that are proving popular and practice at scoring one Type of schoolMeasures used Mainstream secondarySWEMWBS and ORS Mainstream primaryCORS and GBOs AP SecondarySDQ (S, T) ORS, GBOs AP middleSDQ (S, T) CORS AP primaryCORS Special school 4-19SDQ (S, P and T) CORS

9. Opportunities in the use of questionnaire based measures in schools Questionnaire based measures are useful in that they capture subjective feelings and behaviours. They can measure elements that are hard to capture through observation alone. By using in schools, as opposed to in clinics, you’re measuring their natural environment. They can actively make people think about how they feel – often key to changing behaviours. CLINICAL USEFULNESS They can be used for service evaluation and improvement. SERVICE EVALUATION

10. It is important to consider why you are using them: reporting to funders? Supporting focus / communication in sessions? Finding a balance between different types of measure is important… a goal based measure (unique to the individual) a standardised measure (that can be compared) a symptom tracker (to show impact, change) an experience measure, which looks at relationship measures which capture different perspectives (YP, parent, teacher) measures which are used locally (for continuity) Choosing measures Some measures will fall into more than one category EG SDQ is standardised, is a problem tracker and captures multiple perspectives

11. What do young people think about using measures? Reference : Talking About Talking Therapies/Devon CAMHS Views of members of VIK Young Minds It is important to monitor outcomes to make sure the person feels better not worse It makes us feel like there is a point to our therapy It means if we go off track or get a bit lost along the way, we can both figure out how to find the way back again. PROMs help make the balance of power more equal. Makes us feel like it’s a shared experience between us and the clinician... like we’re in this together. Enables us to get an in- depth understanding of what we’re feeling, why we’re feeling it and what we can do about it. Gives us a shared understanding of …where we’re starting from. …where we’re heading to. …how we’re going to get there.

12. Some tools for you to look at: NameSDQSWEMWBSGBOORS / CORSSRS What it measuresSymptoms / problems Positive wellbeingGoalsImpact of problems Session feedback, alliance When is it usedAt assessment and review Session by session Who can use itParent & Teacher 4- 17 & YP 11+ 13+YP in discussion with practitioner CORS 6-12, ORS 13+ & Parent YP and groups Does it have norms? Yes N/AYesN/A This information is given in good faith – it does not include all measures available to you but a selection which might be of interest. Please see our website for more choices and up to date information www.corc.uk.netwww.corc.uk.net

13. SDQ – What is it? Brief screening questionnaire for 2-17 year olds All versions of the SDQ ask about 25 attributes, some positive and others negative. Divided between 5 scales: 1) emotional symptoms (5 items) 2) conduct problems (5 items) 3) hyperactivity/inattention (5 items) 4) peer relationship problems (5 items) 5) prosocial behaviour (5 items) 1 to 4 added together generate a total difficulties score Child, parent & teacher versions, age modified (Robert Goodman, 1998)

14. SDQ - What does it look like?

15. Strengths and Difficulties Questionnaire (SDQ) example items: T1 assessment Robert Goodman There are 5 different subscales: emotional symptoms, conduct problems, hyperactivity scale, peer problems and pro-social. To which do you think the following belong?

16. Scoring the SDQ Each item on the questionnaire fits into one of 5 categories, and each item can be given 0, 1 or 2. The ‘total’ difficulties score is calculated from adding four of the categories (excluding prosocial behaviour) together, giving a score out of 40. You may also find that some of the categories present more strongly than others.

17. Not too long Flexible - can be used for screening, as part of a clinical assessment, as a treatment-outcome measure, as a research tool Normed Translated into 80+ languages Widely used; shared understanding Benchmarking data SDQ Strengths and considerations Some YP less keen on this measure; language LD services don’t always agree on suitability for LD populations Not suitable as a frequent / session by session measure: recommended interval 4-8 months, though some say longer is fine

18. GBO - What does it look like?

19. How to use GBOs To feel more confident, have more friends and be happy

20. Circle the score each time you use the GBO scale You don’t have to score every session - do what makes most clinical sense Sometimes scores may go down – important to see as conversation tool

21. How to use GBOs? You can turn the chart on its side and use it as a run chart to track progress You can use the run chart to facilitate discussions about what is going well or less well

22. Can be a good starting point Can provide structure Can help set collaborative targets for therapy Allow progress to be tracked in a way that is meaningful to young people, recognising progress and building self-confidence. Applicable to a broad spectrum of interventions Complement other measures Can support a strong working alliance Views from interviews with service users at Young People’s Participation project in East Hertfordshire Specialist CAMHS GBOs Strengths and Considerations It is important to set the right goals - achievable Goals can make young people feel under pressure, particularly those anxious about succeeding Need to be aware of what makes a good goal. Need to explore young people’s thoughts about using goals so worries are made explicit and can direct decisions about choice and use of goals in therapy Not normed

23. SWEMWBS- What does it look like?

24. The WEMWBS is a scale that measures mental wellbeing (as opposed to mental illness or disorder) It is suitable for use in the general population. Its strengths are that it is positively worded, represents positive attributes of wellbeing and covers both feeling and functioning. (S)WEMWBS Strengths and considerations The WEMWBS is a scale that measures mental wellbeing (as opposed to mental illness or disorder) It may not suit a specific targeted intervention. The positive wording may lead to being less keen to disclose negatives

25. ORS / CORS What do they look like?

26. Simple to complete Separates different areas of a child’s life: self, family, school, overall. Can be used session by session Available (US) norms Can support a conversation / dialogue about feelings ORS / CORS Strengths and considerations Simplicity makes data less specific, and gives less depth. Might be better for internal comparison than direct comparison with others – change is relative.

27. SRS – What does it look like?

28. Child SRS

29. Things to consider when choosing measures Reliability, validity and sensitivity to change In this pilot we were looking at short term targeted interventions. The measures we used therefore had to be above all sensitive to change, to allow for useful comparison to educational data.

30. 3. Benefits and challenges arising from the pilot

31. Towards a common attainment measure Since the use of National Curriculum levels has been discontinued, schools are using a range of methods for recording attainment and tracking progress. Four possible solutions identified: 1.Bespoke analysis 2.Small number of options 3.Devise common measure a.devise a four point scale for Educational Level akin to the Current View descriptors, and in consultation with school contacts, that schools would fill in, based on whatever they collect. b.Information would be provided on where students sit within their year e.g. bottom 20% c.Information would be provided on percentage distance from target 4.Do not include attainment

32. 3. Devise a common measure Option 3a: Devising a four point scale for Educational Level akin to Current View descriptors but with more sensitivity, especially between Mild and Moderate– for schools to score based on whatever attainment data they collect.

33. 4. CORC for Schools membership models

34. Relevant learning from CORC for Schools Pilot Implications of learning for membership models No dedicated budget Admin capacity Limited IT facilities Report might not be cost efficient

35. Single School Membership The Offer: School Membership Access to telephone and email support and advice about choosing, working with, and understanding data from measures Access to regional and national shared learning events and an opt in e- newsletter with updates, shared learning and latest research Access to membership level day rates if they want face to face support, e.g. training on using measures, capturing or analysing data Access to easy-to-use tools that help schools to do their own simple analysis

36. Interpreting measures data Access to easy-to-use tools that help schools to do their own simple analysis –e.g. an excel spreadsheet into which T1 and T2 data can be entered that generates a graph and contains some guiding text on considerations/ questions to ask yourself about the data –e.g. access to an annual or 6 monthly generic ‘rest of CORC’ benchmark for change in scores against relevant measures e.g. average points change for a goal between T1 and T2 Cost per annum: £300 for a school of <900 pupils, £450 for 900< Single School Membership

37. Cluster or External Provider Membership Access to telephone and email support and advice about choosing, working with, and understanding data from measures Access to regional and national shared learning events A day worth of face to face support time Access to membership level day rates if they want additional face to face support An opt in e-newsletter with updates, shared learning and latest research Full CORC report analysing submitted data against a ‘Rest of CORC’ benchmark The Offer: Normal CORC Membership (with additional fields)

38. Interpreting measures data Unlike the pilot, education and measures data would be flowed together through an AFC owned platform. In order to pick up on aspects of reporting that are important to schools we would make the following additions to the current CORC data specification –Additional field: Attendance (% score measured in a standard way as currently) –Additional field: Attainment (see options below) –Ensure people complete fields stating ‘setting’; ‘professionals present’ – this will enable people to see which data are from school based interventions / delivered by different types of professionals Cost per annum: £1,500 (voluntary) or £3,000 (statutory) Cluster or External Provider Membership

39. Non-member training offer Outcomes measures training available independent of membership Up to 10 people £500 (£350 for members) plus expenses Larger groups negotiable Offer on first year of membership if previously bought training

41. If you have any questions, please contact: Emma Morgan – CORC for Schools Project Manager – emma.morgan@annafreud.org emma.morgan@annafreud.org CORC Office – corc@annafreud.org corc@annafreud.org – 0207 443 2225