Latest analysis has backed the use of classroom-based cognitive behavioural therapy (CBT) to support the mental health of schoolchildren as they face the continuing challenges of the pandemic and catching up on lost learning. However, at a time when teachers will need to provide extra emotional support to pupils, research shows many lack the confidence and skills to do it.
An evidence review by the Early Intervention Foundation (EIF) found that teachers providing whole-class support to pupils through CBT can effectively support students’ mental health.
The review found that CBT interventions, delivered to all pupils, showed particularly strong evidence of improving symptoms of depression and anxiety in the short term.
Such interventions support participants to regulate emotions, identify negative thoughts, establish helpful patterns of thought and behaviour, and develop coping strategies that target solving current problems.
The EIF says the findings suggest schools should focus on the importance of skills-based interventions in improving mental health outcomes; this means putting in place interventions that target sets of skills, such as emotional identification and regulation, communication and resilience.
It adds that such interventions could be implemented by mental health support teams (MHSTs), which are being developed in dozens of trailblazer areas, as part of a whole-school approach. The government wants MHSTs – which improve links between education settings and community-based services – to cover a third of schools by 2023.
Jo Casebourne, EIF chief executive, says: “Schools should provide the mental health support that is shown to work best. We now know that CBT support is shown to work well and that we need to develop young people’s skills to improve their mental health.”
Child mental health organisation the Anna Freud Centre says teachers have an “important role to play” in improving children’s access to CBT but that it would need to be properly resourced (see below).
A study by NatCen Social Research published in July found that secondary school pupils experiencing poor mental health are three times more likely not to pass five GCSEs than peers. This highlights the need to have teachers trained to confidently deliver CBT, the foundation adds.
However, a survey of 4,500 teachers carried out by Teacher Tapp on behalf of the EIF found that two-thirds had not had any training in the previous 12 months and only 50 per cent felt confident in being able to address their mental health needs.
Casebourne adds: “These survey results show the work we think needs to be done to better help teachers so they can support student’s mental health. As good mental health and attainment go hand in hand, we need to focus on it as part of the Covid recovery and ensure a fair opportunity for all.”
EXPERT VIEW
THE VALUE OF CBT IN SCHOOLS AND HOW TO DELIVER IT EFFECTIVELY
By Dr Lesley French, head of clinical help in schools, the Anna Freud Centre
There is a substantial body of evidence regarding the efficacy of cognitive behavioural therapy (CBT) for the treatment of mental health problems which are common in children and young people.
CBT sets up a collaborative approach with the young person, agreeing goals at the outset of the intervention and a rigorous approach to outcomes. For the most common childhood difficulties – anxiety, low mood or depression, and behavioural difficulties – there is an evidence base for utilising a CBT approach as a first line of approach. However, only a small proportion of children and young people can currently access these approaches.
Schools have a critical role to play in increasing access to evidence-based interventions for young people who have a treatable condition. This can enable a swifter response, so their difficulties can be addressed at an early stage and reduce the need to refer to frequently overwhelmed child mental health services.
Teachers and school staff are experts in relation to children and young people, and they can be trained in the key elements of CBT – through presenting a model for managing common mental health difficulties in children. All of this is dependent on capacity within schools.
Evidence-based CBT approaches can be adopted by schools via a universal or targeted approach. Another approach is classroom or assembly-based delivery of psycho-education about anxiety or low mood, with practical strategies based on evidence-based treatment. In addition, or as an alternative, schools can receive assistance to train teaching support staff to deliver focused interventions currently being piloted by the Anna Freud Centre. It is also working with Place2Be to train school-based counsellors, and provide support for teachers, pupils, parents and carers to deliver and benefit from CBT-informed counselling.
School-based approaches to using CBT can be highly successful. An added benefit is that they have the potential to reach large numbers of young people in a non-stigmatising way. As we seek to open up more conversations about mental health, this is to be welcomed.
FURTHER READING
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Adolescent Mental Health: A Systematic Review on the Effectiveness of School-Based Interventions, EIF, July 2021
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NatCen Social Research Analysis of Understanding Society Pupil Survey, July 2021
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Early Evaluation of the Children and Young People Mental Health Trailblazer Programme, July 2021
