Organisation submitting example
A Quiet Place® (AQP)
Local authority/local area:
Liverpool: North West
The context and rationale
A Quiet Place® (AQP) is a holistic action learning programme. Its main objectives are to improve the wellbeing of children and to develop their emotional intelligence to improve their learning and educational attainment.
The programme provides holistic support in order to meet the needs of pupils, parents/carers and staff. It is particularly well suited to addressing the needs of pupils at risk of exclusion from school and to preventing the development of socially unacceptable behaviour or later mental health problems. Each school AQP works with decides with AQP and the parents, which children to prioritise – known as Protocol children – but all children in a school will have a chance to experience AQP. The school funds the programme, usually as part of its behaviour management programme.
AQP is described here, working in an independent residential and day school and registered children’s home for 65 pupils with severe social and emotional difficulties aged 7-19 years. Pupils have single and multi diagnosed conditions including attention deficit hyperactivity disorder, autistic spectrum disorder, and attachment disorder, bi-polar disorder, obsessive-compulsive disorder, Tourette’s syndrome, depression, grief/loss and bereavement, conduct disorders, self harm, psychotic disorders and inappropriate sexualised behaviour. Most pupils have associated mental health issues and Child and Adolescent Mental Health Services are accessed up to and including Tier 4.
A programme of holistic approaches has been installed by AQP, a company that grants a license to the school to utilise and quality assure a range of personal development programmes that are delivered in a specially created multi sensory healing environment that allows the pupils to experience non-forensic interventions without feeling pressured or stigmatised.
Originally the school approached the company to explore options for shifting to a more proactive approach to delivering services and therapies to its pupils. At that point the school subscribed to an external multi-agency support team that became involved with pupils following a cause for concern. Additionally the school has its own team of specialists including psychiatrists, psychologists and therapists. Subsequently the school extended its already comprehensive range of interventions by adopting the AQP programme.
The school now includes the AQP programme as part of its policy and therapeutic pathway (DCSF, 2010). Importantly the programme offered has broadened access to include staff and parents/carers, effectively promoting social cohesion within the school community. Pupils witness staff members accessing the facilities, thus demonstrably ‘normalising’ universal access to the programme whilst simultaneously promoting good health and wellbeing and raising morale amongst all members of the school community.
A key component of the programme is the training of school staff to be able to deliver the programmes for themselves. This results in a broadening of skills and expertise and is building capacity and sustainability. Consultants from the company work alongside school staff for short periods to coach and provide training ‘on the job’. Regular supervision from AQP senior therapists assures quality in delivery and safety of individuals engaged with the programme. Relatively quickly school staff become acquainted and equipped with skills, knowledge, expertise and resources to carry forward developments for themselves.
The programme is monitored - including benchmarking of stress levels. The achievement of unique outcomes is central to gauging the impact of the programme. A documentation process is overseen by an impartial third party and an annual impact report records achievement of outcomes for all users.
We wanted to improve emotional wellbeing and we know, from research and guidance, that building emotional resilience makes a positive difference to young people’s lives.
The establishment of AQP in this school setting involved the creation of a themed multi-sensory, healing environment which serves to immediately calm and emotionally engage those who enter the space (Spalding, 2001). The environment is equipped with practical and creative resources with which to deliver the three main approaches which characterise AQP interventions. Firstly, the emotional intelligence curriculum; secondly, the self management programme (including computer biofeedback programmes) and thirdly, body work – massage.
One session of each of these three approaches is delivered weekly, amounting to input to an individual of approximately one hundred minutes per week over a 6 week period, which usually fits neatly into a half term. Pupils are supported on an individual basis in two ways:
• Through protocol work, which is a focused, intense programme of work, consisting of 100 minutes (3 sessions) every week for 6 weeks; and
• Through non-protocol work, which is individual sessions delivered as and when necessary.
Further research evidence on this protocol is available here.
Other Support from AQP
In addition to the core support provided by AQP working with pupils on an individual basis, substantial additional support is provided to the school through work with parents, staff and groups of individuals (please see the Impact Report ‘Other Support from A Quiet Place’, pp. 8, 10, 12). As the programmes roll out across the organisation, groups may use the space for relaxation sessions and additional programmes - such as Breathing Space - which has similar benefits to Circle Time (Mosely, 2005).
Assessments are carried out by in-house staff (who have been trained by AQP) pre and post protocol with referred pupils, and where appropriate, their teachers/support staff, parents and/or carers. The resultant, anonymised data from all participants contribute to an annual Impact Report (see attached) where outcomes are reported back to the school.
The therapeutic protocol is described further here (under 2a).
The implementation of the AQP programmes began in this host school in summer 2009 with a series of strategic meetings where leaders from AQP and the school nominated ‘champions’ from school based staff to act as change agents across the organisation. The champions then identified a ‘facilitator’ who was a member of the care staff employed by the school. The facilitator’s task was to deliver the programmes to the pupils whilst simultaneously undertaking AQP action learning programme of study – elements of which are designed to mirror and promote reflection upon the various therapeutic approaches. The facilitator began work with pupils as soon as the environments had been installed. Timescales, roles and responsibilities, training commitments, timetabling and resources were explored by the leaders from the host school and AQP and a customised roll out of programmes was produced. During the first half term:
• Two AQP environments with contrasting themes were designed and installed
• Awareness raising events and individual and small group inductions were timetabled for all members of staff and peripatetic specialists
• Training of the facilitator began and a body worker was recruited to deliver massage to young people and adults (staff and parents)
• Pupils and staff began to sample AQP programmes
The trainee facilitator began to deliver the eighteen protocol sessions on an individual basis to some pupils. An in-house referral system was set up that links into each of the specialist therapeutic resources at the school, thus offering a holistic package of education, care and therapeutic interventions.
Evidencing your practice has made a difference to children, young people and families
Data is collected by the school based facilitators working in the school with the pupils, staff and parents and is collated and evaluated by AQP. This data is monitored and gathered rigorously. However it is subjective data gathered through self evaluation and triangulated benchmarking techniques. Each participant is identified by a unique reference number known only to the facilitator and data taken from each individual is recorded using AQP documentation. Data is entered on to spreadsheets, collated and the results formulated into an Impact Report for the school.
AQP has been the subject of an action research Ph.D. During the study large amounts of data were collected using many and varied capturing techniques, including Boxall profiles (Bennathan and Boxall, 1998), followed by rigorous scrutiny and analysis (Renwick, 2004). Since the completion of the project, data collection has been ‘slimmed down’ considerably, though quality control and monitoring remain ‘built in’ to the protocol. One of the challenges for the organisation is to balance data collection to satisfy the need and demonstrate efficacy to purchasing partners, whilst simultaneously ensuring that the activities remain enjoyable to the pupils, parents and practitioners who engage with the project. AQP activities may look ‘soft’ to the observer. The challenge is to evidence that the programmes can and do produce positive change.
The internal data collection and monitoring procedures are inseparably linked into the operational processes. Throughout the relationship the triangulation of subjective data from parents, staff and from the pupils themselves and finally from the facilitator has been and remains incorporated into the protocol.
The following improvements were measured using a variety of techniques, including verbal feedback from pupils, parents and staff both informally and from pre and post intervention interviews; observations by teachers; rated scales to show, for instance, deterioration, no change, a little improvement, a big improvement; questionnaires and supervision of school based facilitators by senior AQP psychotherapists.
We expected improvements in:
• academic performance levels
• academic motivation levels
• pupils’ stress levels
• adults’ stress levels (staff and parents)
• body language (body posture, tension, facial expression, eye contact and acceptance of touch)
• pupils managing their feelings
• pupils’ self awareness
• pupils able to calm themselves down quicker than before the intervention
• pupils improving on their unique outcomes from the point of view of all parties involved (pupil, teacher, parent)
• improvements across all areas of well being for pupils
Numerical data was taken over three terms – April 2009 to April 2010. All 65 pupils at the school accessed AQP at some level. 884 sessions were delivered to pupils on an individual basis. 28 pupils have undergone the protocol (one session of emotional intelligence curriculum, one session of self management and one session of massage, weekly for six weeks, making eighteen sessions in all for each of the 28 protocol pupils). The remaining 37 pupils have accessed non-protocol work – individual sessions delivered as and when required or requested. These sessions include self management, massage and relaxation. Additionally there has been some group work.
Detailed outcomes for the 28 pupils undergoing the whole protocol are available here under (3) and feedback from pupils and the leadership team at the host school can be read here (under 3a).
1717 AQP sessions have been delivered overall to pupils and adults at the school.
AQP responds to evidence and to suggestions from participants through the process itself as well as through National Training events on a twice yearly basis when all staff from all partner organisations are invited to come together in Liverpool. Attendees receive ongoing training and explore what is working well, as well as comparing and sharing practice across the country and across different host organisations, e.g. mainstream/residential/special school/college, children’s centre, children’s homes.
Helping others to replicate your practice
The full protocol costs £360 per child; this cost covers 18 sessions of a 6 week programme for each “Protocol child” including sessions with parents and staff. This cost will also cover access to the programme for all children in the school.
Initial difficulties, and how they were addressed
To some people AQP appears ‘soft’ and its effectiveness had to be proved to often highly experienced staff working with very challenging pupils. Hearts and minds needed to be won over and that meant trying to reach every member of the school community and demonstrating positive results at every possible opportunity.
The school staff is comprised of 19 teachers and 127 non teaching staff working across all areas of the school to provide various levels of education, care, administration and domiciliary services. Considerable time and effort was spent arranging for and delivering awareness raising presentations, including demonstrations of the computer biofeedback programmes, across this large and varied staff group.
Well established therapeutic interventions were being delivered by specialists including a consultant psychiatrist, clinical psychologists, educational psychologists, a speech and language therapist, person centred counsellors, a play therapist, family therapist, cognitive behaviour therapist, art therapist, horticultural therapist, mental health practitioner and a solution focused therapist.
These specialists were invited to collectively attend and participate in a mock-up programme of the emotional intelligence curriculum that was delivered to the group of specialists once a week over 6 weeks by AQP staff. Leaders from the school based staff, including the champions and the trainee facilitator also attended.
An enhanced level of input for staff (“Wellbeing in the Workplace”) has included Indian head massage, remedial massage, individual and group relaxation sessions, psychotherapy to address stress, smoking, weight loss and personal issues, homeopathy and reflexology. The specific therapies that have been offered were determined through results from an individual audit that gathered information about each member of staff’s subjective, holistic view of personal wellbeing and then pooled that anonymised information to provide a strategic approach for the entire staff group.
Parents were difficult to engage with. Many parents/carers live long distances from the school and others did not always attend when they were invited to visit. Key workers or senior members of staff who knew individual parents well phoned them to share information about AQP and to encourage them to attend and participate in pre- and post-programme assessments. Where parents were not accessible or available staff key workers completed the assessments on their behalf.
There was also a data collection issue. Protocol pupils were relatively straightforward to track; however non-protocol pupils were sometimes counted twice or more. Consequently, although the total number of 884 sessions delivered to pupils is believed to be accurate, we have omitted the breakdown of the exact input delivered to each of the non-protocol pupils from this account and reported only on the 28 protocol pupils. Amendments have now been made to data collection for non-protocol pupils.
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