Tackling anxiety and school attendance in Northamptonshire schools Report and analysis of the School Anxiety Survey – Summer Term 2017 The local authority is currently considering the feasibility of a project to support Northamptonshire schools focusing on anxiety and school attendance. This new project would be facilitated by the Educational and Inclusion (EI) Partnerships Service and the Educational Psychology Service (EPS) and may involve other agencies. In June 2017, a Survey Monkey questionnaire was created by Rachel Eastwood (Specialist Senior Educational Psychologist for Social Inclusion) and Poppie Brennan (Psychology Assistant) and circulated to all Northamptonshire schools via The Friday Bulletin. The survey asked schools across Northamptonshire for expressions of interest in this project and for their data on anxiety and school attendance. Disappointingly, only 16 representatives from 14 different schools responded. This was in spite of EI Officers and EPs promoting the survey in their work with schools. Thus, the data that has been collated and analysed is a self-selected sample of schools and is subject to bias. There may be a range of reasons and motivations why school staff did or did not take part in the survey and these are not known at the time of writing. Whilst the data is interesting it must be interpreted with caution. A total of 7 primary schools and 7 secondary schools participated in the study. The primary and secondary schools who participated in the survey came from 4 geographical areas of Northamptonshire, see table below; Northampton Daventry / SW

Primary schools Primary schools Cedar Road Primary Crick Primary Malcolm Arnold Prep School St Gregory’s Catholic Primary Whitehills Primary

Secondary schools Secondary schools Elizabeth Woodville School Guilsborough Academy The Parker Academy

Wellingborough / EN Kettering / Corby

Primary schools Primary schools Finedon Mulso Junior Irthlingborough Junior

Secondary schools Secondary schools Wrenn Academy Southfield School for Girls

Staff from Kettering Science Academy (KSA), Danetree and Southbrook Learning Village (DSLV), Guilsborough Academy and The Parker Academy have all expressed an interest in the project although two of these schools did not complete the survey. We asked schools if they would be willing to make a financial contribution towards this work. From the 14 schools who responded only 5 said that they would be willing. These schools are listed below;

• St Gregory’s Catholic Primary • Elizabeth Woodville School • Guilsborough Academy • Irthingborough Junior • Wrenn Academy

We asked participants to state their role in school. The data collated indicates that 13 out of the 16 who responded were members of the senior leadership team in school. See below; 3 Headteachers 1 Acting Headteacher 5 Deputy/Assistant/Vice Principal 4 SENCos/Head of Inclusion 2 Family Workers 1 Attendance Support Officer

The survey asked school staff how they established that a pupil’s absence was anxiety related. The themes that emerged from the qualitative data and the frequency of these themes are detailed below;

• 5 schools talked about having a discussion with the pupil • 8 schools talked about having initial communication with parent/carer • 5 schools have created a system of gathering data from school staff (including the School Counsellor and their Pastoral Team) • 3 schools looked for patterns in absence data • 3 schools held meetings with the pupil • 5 schools held meetings with parents/carers (including a Parent Contract Meeting) • 6 schools responded to formal notification by a medical professional (e.g. GP, CAMHS, School Counsellor) and responded when there was evidence of anxiety attacks

We analysed the pupil data provided by schools. Out of the 2058 primary aged pupils 42 of these were identified as having school attendance issues related to anxiety. This has been calculated as around 2 per cent of the sample population. We asked schools to classify these pupils by year group. See table below for results. It must be noted that this data is approximate and has not been verified with individual schools for accuracy.

Approximately how many pupils in your school have attendance issues related to anxiety? 14

12

10

8

6

4

2

0 Reception Year 1 Year 2 Year 3 Year 4 Year 5 Year 6

The graph shows that the majority of pupils experiencing difficulties in school were in Year 5, followed by Years 4, 3 and 6. Out of the 7900 secondary aged pupils 181 of these were identified as having school attendance issues related to anxiety. This has similarly been calculated as around 2 per cent of the sample population. We asked schools to classify these pupils by year group. The majority of pupils experiencing difficulties were in Years 10 and 11 followed closely by Year 9 (see table below). Again, it must be noted that this data is approximate and has not been verified with individual schools for accuracy.

Approximately how many pupils in your school have attendance issues related to anxiety? 50 45 40 35 30 25 20 15 10 5 0 Year 7 Year 8 Year 9 Year 10 Year 11

We invited schools to provide details of the strategies they had found most helpful. These are summarised below;

• 4 schools used reduced / part-time timetables • 8 schools identified a key adult in school to offer support / mentoring • 2 schools identified peer support / buddying • 3 schools organised individual intervention work (e.g. counselling, coaching) • 2 schools organised group work following a structured intervention programme • 1 school organised internal / external alternative provision • 4 schools mentioned home visits / close communication with parents • 3 schools mentioned working with outside agencies, such as CAMHS • 2 schools used Time-Out cards • 2 schools identified a safe space in school for pupils experiencing anxiety • 2 schools used a Meet and Greet strategy • 1 school analysed key triggers and developed tactics on how to avoid them

We asked schools what support they had received from outside agencies. They responded as follows;

• 5 schools had received support for pupils from CAMHS • 3 schools had received support from EIP (e.g. supporting school staff to meet with parents) • 1 school had received support from JOGO • 1 school had received support from their link EP • 1 school had received support from their School Nurse • 2 schools had contacted the GP for the pupil • 1 school had received support from Hospital and Outreach Education • 3 schools had used the Early Help procedures to access support (e.g. from Service Six - The Bridge Project)

We invited schools to share their success stories. The case studies below are taken from the qualitative data provided by school staff; Case Study 1 – A Year 7 pupil was supported through daily Meet and Greet, peer buddying and a reduced timetable. Service Six counselling was offered. Parents engaged with an Attendance Contract and, following weekly review meetings, there was a gradual increase in the pupil’s attendance rate. Case Study 2 – A Year 12 pupil had low attendance in Year 11 due to anxiety and stress. This had an impact on his GCSE results but the school made the decision to support him through to Sixth Form. His attendance improved in Year 12 and he repeated GCSE exams in English and Maths. The pupil is now described in Year 12 as a confident learner and young person. Case Study 3 – The school ran a structured small intervention group to support students to recognise early warning signs, to develop coping strategies of how to seek support before emotions escalated and taught them Mindfulness techniques. The incidence of absence due to somatic symptoms (e.g. tummy aches and headaches) decreased for pupils within the group. We asked school staff how they thought Northamptonshire County Council could best support their school to reduce anxiety for pupils. Below is a summary of responses;

• 5 schools requested training for staff and the following topics were identified; o Advice on what schools can to do reduce anxiety for pupils, o Managing anxiety related attendance concerns, including the impact of mental health, o Providing / recommending resources

• 3 schools would like additional support to provide help, advice and training for parents around the impact of anxiety, • 2 schools would like support around hard-to-reach parents, • 1 school asked for support and strategies with getting pupils back in to school, • 1 school would like strategies for students, • 2 schools would like greater access to counsellors, • 2 schools requested support around referrals to outside agencies and waiting lists.

We asked participants if they wished to make any further comments. Below are quotes taken directly from participants in the survey; “Generally anxiety is not well identified and supported and there is little within school structures that are able to offer appropriate levels of support without the school being penalised. The system needs to better understand and reflect the complex nature of anxiety related concerns and offer meaningful and durable support which is currently broadly unavailable “ “Students with anxiety and stress related issues seem to be on the increase”

Suggested next steps in response to the survey data We acknowledge that the response to the survey has been disappointingly low. However, it is possible to plan a way forward based on the feedback received and link this to current psychological research on school refusal. What emerges as a strong theme from the survey is the need to increase staff knowledge and skills. There is also a need to strengthen processes within schools for identifying and working effectively with anxious pupils. We propose that this could be tackled by; 1. Updating the Northamptonshire Anxiety – Tackling It Together booklet which provides psychoeducational materials for children and young people, parents/carers, teachers and other professionals. This could be launched at a conference.

2. There is already anxiety training as part of the TaMHS training offer and this could be delivered and extended to include anxiety issues related to school refusal.

3. Research identifies the need to establish the function of the school refusal behaviour and there are assessment tools which would enable this, such as the School Refusal Assessment Scale (Kearney and Silverman, 1990). Research also recommends prescriptive individualised or group intervention work and the most effective programmes appear to be based on cognitive behavioural approaches. These interventions for pupils have common content which focuses on;

• Exposure to the feared stimuli / situation in school • Relaxation training • Contingent reinforcement for school attendance • Cognitive restructuring, i.e. helping the student to recognise their distorted thinking patterns and attributions • Developing coping plans An intervention model by King et al. (1998) recommends an individual intervention programme of 6 X 50 minute sessions delivered across 4 weeks. This work is targeted for those pupils whose school absence is related to negative reinforcers, i.e. where nonattendance is related to; i. the avoidance of stimuli which provokes negative emotions (e.g. physical aspects of the school environment, the curriculum, exams, teaching staff), and/or ii. escaping aversive social or evaluative situations perhaps due to severe social anxiety (e.g. peer relationships).

4. Research by King et al. (1998) recommends 4 X 50 minute parental workshops alongside this and these sessions could be offered for parents/carers on a group basis for schools and/or a local community. This would require preparation of training materials. The general aim of parent/carer support is to help them understand the possible reasons and negative cycle of school avoidance behaviours, to help them plan the process of escorting their child back to school, support them to cope with potential feelings of guilt and to develop positive reinforcers for coping behaviours and attendance.

5. Systemic work is needed to build capacity in schools in identifying, understanding and intervening effectively for pupils experiencing anxiety. This could be tackled through the Emotional Literacy Support Assistant (ELSA) training which is being rolled out to the first cohort of ELSAs in 2017-18, with regular follow up supervision sessions with an EP.

6. Creating a school checklist / process for helping school staff to identify attendance issues related to school anxiety may lead to an earlier and more effective identification of the problem for individual pupils, e.g. exploring patterns in attendance data. This could be used in conjunction with a process chart of when and how to seek support within and outside the school system.

7. A whole school audit tool may help schools to think systemically about why anxiety levels are increasing for pupils in their environments and incrementally across the age range. Schools need to develop safe and secure environments, build trusting staff and pupil relationships and have excellent communication and relationships with parents, they need to provide a culture which promotes a strong sense of belonging to the school and support teachers, non-teaching staff and pupils to understand and effectively manage their emotions.

8. Advising schools to invest in improving the emotional wellbeing and resilience of staff would increase their capacity to deal with pupil anxiety. There are many good intervention programmes which EPs are already trained in, e.g. FRIENDS Adult Resiliency and Keys to Happiness

9. A working group of EI Officers and EPs could take this work forward and establish an intervention package based on similar lines to the social inclusion project work. This would ensure consistent and coordinated external agency support with reference to evidence based assessments and interventions.

All of these suggested ways forward have implications in terms of identifying appropriate staff, time, resources and funding.

Refer to the attached document, Developing Effective Support Systems for Young People Experiencing Anxiety Based School Avoidance: An Exploratory Study and Good Practice Guidance for Schools, and the website produced by Babcock LDP Educational Psychology Service http://www.babcock-education.co.uk/ldp/absa for examples of good practice in this area.

This report has been written by Rachel Eastwood (SSEP for Social Inclusion) and Poppie Brennan (Psychology Assistant) 09/08/17