Much of the research examined supports whole-school approaches to intervention (Campbell et al., 2016; Dix et al., 2012; DoH, 2015; PSHE Society, 2015; Vostanis et al., 2013; Weare & Markham, 2005), however, the data collected for this study challenge this assertion. Substantial benefit was seen in the dual implementation of targeted and UI, and despite numerical data demonstrating somewhat limited changes for universal participants, it could be argued that had the project been sustained over a longer period of time, its benefits would have been to seen to be more substantial. As has been highlighted, outcomes were seen to be more positive for TPPs, who reportedly improved in their emotional regulation as a result of the double-stranded intervention, some significantly so (for example TPP5B. See Table 4.2). This would suggest that this approach to intervention was effective in that those children that needed it the most, gained the most benefit.
Prior to commencement of the TI, the children’s theatre director first came into school. The teacher-researcher asked TPP6A to take him on a tour of the school and he did so in a polite and friendly manner. After the tour however, the theatre director did a workshop with all of Class 6A, and immediately TPP6A’s behaviour deteriorated and he shouted that he was bored and did not want to participate. This would suggest that perhaps this child in particular would have responded more favourably had the intervention been carried out on a 1:1 basis, rather than within a group. These findings would contradict the arguments of Campbell et al. (2016); Dix et al. 2012; Vostanis (2013) and Weare and Markham (2005), in that had this intervention been solely implemented using a whole-school approach, a child such as TPP6A, with his particular difficulties, would fail to make progress, and would actually hinder the progress of others in a whole-class setting.
One child who was identified to be a sixth TPP from Y6 was initially given permission to take part in the TI, and then withdrawn by his parents. This parent was from a BEM group and spoke EAL. It could be argued that this withdrawal was related to a sense of stigmatisation as described by Kurtz and Street (2006) who reported that the stigma of seeking help from MH services is more marked amongst parents from BEM backgrounds, and can prevent
vulnerable children from accessing support. The child in question was however permitted to take part in UI, and his answer to the final extended question in the SJT demonstrated that he perceived the UI to have been significantly impacting:
The project helped me so much … I won’t forget these skills. One of the best skills is knowing the difference between being assertive or aggressive … this project that helped me so much.
These findings support research conducted by Domitrovich et al. (2010), NICE (2013) and Shucksmith et al. (2007) who advocate a combined approach to intervention (TI and UI), suggesting that this results in a broader influence on pupil EWB and maximises exposure to intervention. Using this child as an example, where involvement in a TI was seen to be stigmatising, he was still permitted to take part in the UI, and therefore still accessed support for a key area of his EWB. Deighton et al. (2013) support this, arguing that schools which adopt an integrated approach to intervention using a range of different strategies, are most successful in supporting the emotional health of primary pupils, as well the behaviour of at- risk pupils. Certainly TPP’s key role in the development of UI clearly gave the pupils a sense of empowerment and pride, further consolidating key messages from the intervention and therefore enhancing its efficacy (Appendix II-e).
In contrast, Vostanis et al. (2013) assert that UI for mental health (MH) is preferable to TI due to its cost-effectiveness, in that schools would not have to fund training for specialist teachers or use external agencies in the provision of TI. The results of this study however support the argument that rather than cost-cutting in this way, extra funding is essential to provide integrated intervention. Without doing so vulnerable pupils in particular need would fail to receive the personalised support they require, for example TPP5B.
Campbell et al. (2016) and Weare & Markham (2005) argue that whole-school intervention avoids stigmatisation of individuals and groups. Eccleston and Hayes (2009) suggest that targeted pupils would perceive themselves to be damaged or fragile in comparison to their peers. Interestingly, in opposition to both these arguments, when asked whether or not they had liked having their comic strip as a focus for UI, all the TPPs responded positively and with a sense of pride in what they had achieved, for example, TPP6B (Appendix II-e): … It gives me fun memories and whenever people are looking at it and they see that it’s me … And like now everyone knows me … It was fun.
Furthermore, the teacher-researcher observed that within UI lessons, UPPs reacted positively towards the comic strip produced by and featuring TPPs, saying the resource was ‘cool’ and complimenting their peers on its quality and content. When first recruiting pupils to take part in the TI, children were keen to be involved, and actively sought out the researcher to request inclusion in the project. This suggests that not only were pupils happy to take part in TI, but that their peers were also respectful as well as supportive of their involvement.
Teachers were also positive in their assessment of the dual intervention format and
commented on the relevance of the comic strip developed within the TI. They suggested that this enhanced the outcomes of the UI, with the characters, events and setting of the comic strip being immediately more relatable for UPPs (see Appendix II-e).
I liked the fact that they could see that it was actually real children that they know, on their own playground and could all relate to it, and say actually that does happen to me, and I should be trying these strategies to get away from it.
The teacher-researcher also observed a substantial rise in levels of engagement from pupils in Class 6A, both TPPs and UPPs, when the comic strip was introduced as a focus for the lessons. In addition, the class teacher of Child 5B and 5C discussed the effect this had on TPPs, who he observed to have felt proud of what they had achieved: ‘just children seeing
themselves – something they could be proud of,’ (Appendix II-e).
Responses to questionnaires from UPPs were varied, however 63.93% of pupils answered positively, explaining that either the intervention had helped their own emotional regulation, or that of their peers. Significantly one Year 5 pupil wrote:
I’m a bit lonely and sad and some call me idiot and fat and I wanna go home and at play I try to play football but X says I’m dead and I hate my life and no one likes me, not even my teacher. I’m a loner.
Fortunately because the pupil had disclosed this information within UI, targeted action could be taken to try to support the pupil’s EWB on an individual, targeted basis. Such a disclosure in this context would support the use of integrated approaches to intervention, ensuring maximum outcomes for all pupils.