Exploring the outcomes of Thrive: Short‐medium term - Children and young people

This report begins to piece together the Theory of Change for Thrive, a story of how Thrive impacts on the world through its varying outcomes and the relationship between them. 

These relationships are important, as often one outcome will lead to another. Similarly, an outcome for one set of stakeholders will have ramifications for others. Despite its inherent simplicity in terms of approach, the way that Thrive is implemented and the contextual factors that shape this implementation are often complex and non‐linear, and the storyboard of outcomes reflects this.

Despite the need for in‐depth exploratory work to tease out and piece together the outcomes, it was important not to lose sight of the fact that, ultimately, the aim was to assemble an impact map of material outcomes for the computation of an Social Return on Investment ratio; material outcomes being those which are both relevant and significant. Often such outcomes weren’t immediately identified but emerged from in‐depth discussions around the way that Thrive can play out in varying situations and the myriad of factors that influence its trajectory along the way.

The fact that one outcome will often lead to another means that the material outcome may in some cases be a secondary outcome, or happen indirectly as a result of something else. Timeframes are therefore important and as such the interviewees were also asked to consider the extent to which outcomes happen over the short, medium and long term, as well as the factors that can make one outcome lead to another across these timeframes.

An obvious question then is, how were short, medium and long term defined? Discussions around this were undertaken with all interviewees, and the answer (as one might expect) was that it is not straight forward, it is context dependent and is influenced by the age and developmental stage of the child receiving Thrive.

Broadly speaking it was felt that initial changes could be expected to be noticed within the first 3 months of implementing a Thrive action plan; although in some cases this initial phase could extend up to 6 or 9 months. When considering medium term impacts it seemed logical to consider a time period ranging from around 6‐9 months up to 3 or 4 years, depending on specific contexts or circumstances.

So in the majority of cases discussion around longer term outcomes encompassed those which might occur beyond 3 or 4 years but potentially up to 10 or even 20 years following the implementation of Thrive.

The precise definitions weren’t as important as the process of thinking about how outcomes might play out over various timeframes. Thinking this way helped interviewees to not only identify the outcomes, but also to consider how they might lead to further outcomes and what the longer term ramifications might be. Thus it became very much a part of piecing the story together, with the temporal elements forming the structure of the storyboard.

Nevertheless, the loose definition of time frames poses a question of how best to present the findings so as to illustrate the temporal nature of the outcomes, and of course the relationship between them.

To achieve this, outcomes are divided loosely between those that occur over the short‐medium term, and those that occur over the medium‐longer term.

Also following the pattern and substance of what was derived in the interviews, and to avoid any confusion or ambiguities, the outcomes are structured around stakeholder type, although in a number of cases an outcome for one stakeholder may have important ramifications for another. The case of how changes in a child’s behaviour might impact on their parents or siblings being an obvious example.

In a series of short impact reports, the outcomes are described for the following sets of stakeholders.

• Teachers and support staff
• Children and young people
• Parents, families and foster carers
• Professionals working in children’s services

Short‐medium term outcomes - Children and young people

The precise nature of the impact on the children who participate directly in Thrive activities for the purposes of addressing specific emotional and behavioural problems obviously varies depending on the nature and severity of the interruption and the developmental stage of the child in question. It is not the purpose of this report to rehearse precise impacts, which may encompass appropriate learning outcomes or short term achievements. What we are interested in here is the outcomes of this intervention, and in this regard it is possible to be fairly generic, whilst recognising the various specificities and nuances which will affect the precise nature and trajectory of the outcomes in question.

The initial changes that a teacher would hope to start seeing in the first few months of a Thrive action plan are not so much academic but very much based around emotional, behavioural and developmental issues; on improving a child’s emotional health and well being. A child making good progress would be better able to express themselves, and to identify and talk about their emotions. In turn they would be better able to develop relationships and friendships with their peers and more able to ask for help when they needed it.

Thrive is the first time I have seen Attachment Theory translated into very doable, practical things….. something really accessible which says, lets not fuss too much about what kind of attachment disorder it is, lets just accept that what this child needs is a close relationship; how do you do that in the context of your setting and here are some practical strategies. That has been the big difference I think…its about getting underneath.

By the teacher having a greater sense of awareness of themselves, and the needs of children, they are able to empathise more and gain the trust of the child, which can have important impacts on their safety as well as their ability to seek help with learning and general life around the school. And through having a better sense of who they are, their sense of belonging also improves, which helps to develop social skills and the ability to participate more in class activities and work in a group. And through working with others on Thrive related activities they often realise that there are others with similar problems, reducing the feelings of isolation.

Another important strand in this whole process is the raising of self‐esteem, and with it gaining an improved understanding of themselves as an individual. In turn this helps to build emotional resilience. Many children with interruptions suffer from low self‐esteem and low self worth, and this can often manifest itself in violent or damaging activities such as being bullied or being violent to others due to their own insecurities. Armed with a greater sense of self worth, sense of belonging and trust, the child then grows in confidence, is more motivated and is better able to engage in learning and understand their own skills and abilities and how to extend them. And of course all of these attributes then form the bedrock of the longer‐term outcomes which are discussed in the following section.

One interviewee described the example of a four‐year‐old child who was showing symptoms of ADHD. A Thrive assessment revealed a possible Doing interruption.

Depending on the developmental stage there will be a number of possible outcomes for a child’s own education and learning over the short to medium term. With an improved capacity and ability to learn, faster progress will be made through curriculum activities and attainment levels improved. At primary level there may be better SATS results and then later at secondary level improved GCSE results. At secondary level improved exam results could occur within a shorter time frame. But there is considerably more depth to this improved learning process than simple metrics of basic attainment, and they need to be considered alongside the powerful improvements in emotional health and well being, self esteem, trust, a sense of belonging and improved relationships with peers, teachers and often their own families.

While the main focus to date in Thrive has been on primary schools, there were strong arguments put forward for a more prolific roll out of Thrive in both Early Years and Secondary schools. Early Years in particular was seen as potentially very beneficial, not only because the interruption is being addressed more quickly and therefore has less time to become engrained in behaviour and feelings, but also because it is easier to gain the support of engagement of parents. This is because parents of EY children are often more used to dealing with professionals (because of their more recent contact with midwives etc) and can be more accessible to carers at picking up and dropping off times. Parents of older children, on the other hand, may be less easy to convince and engage with on issues relating to their child’s beahviour, and some may even consider it to be too late to make any meaningful changes.

At whatever stage Thrive is implemented, once progress starts to be made it is easy to see why the teacher would have more time to devote to other members of the group, the principle reason being that there is less disruption in the class from children with interruptions. And of course less disruption in the classroom can have other related and long lasting outcomes for all children in the class, with a greater capacity to concentrate, work more effectively in groups and achieve higher levels of attainment over the medium term. This, compounded by the impacts of teachers own increased self awareness and ability to recognize and understand problems, can mean that the working and learning and environment quickly changes.

Of course there are caveats and some cases will progress quicker and more smoothly than others for a variety of reasons. It is also argued that Thrive activities can work quicker and better when whatever caused the interruption in the first place has passed. So, for example, if a potential cause was substance abuse by the mother at an early age and this is continuing, then progress for the child will inevitably be much more of an uphill struggle. And of course where a child has cognitive or other complicating issues that make processing information more difficult then this will affect the speed and direction of progress.

Whole school or whole class work can also have a greater indirect impact on children who don’t necessarily have an interruption themselves, but who can benefit from an increase in awareness of how issues like separation and loss can affect all children. One stakeholder described how the whole school approach is very important, for example in dealing with issues like bereavement.

But even in cases where a whole school approach doesn’t exist the modeling associated with Thrive, and the processes of ‘attuning’ with children’s feelings will impact to some degree on all children. The underlying philosophy of Thrive, itself instilled through the impacts the approach has on developing the self awareness and way of thinking of teachers and carers means that all children in a class or school are likely to benefit from Thrive, to varying degrees and in different ways. In part this is because a core element of Thrive is embedded in the adult‐child relationship, and the modeling of Thrive and practicing of its most basic elements will reach out beyond those identified as having an interruption.

For more severe cases the outcomes of Thrive can be even more pertinent. And a major reason for that is the clear potential of Thrive to reduce the number of children being permanently excluded. To begin to unpick the outcomes of this it is important to consider the impacts of exclusion on a child’s learning experience and life going forward, and the view was expressed that in many cases exclusion can have long lasting damage for a child and his/her development.

Being permanently excluded can therefore have potentially huge ramifications for a child in terms of their life chances going forward. Thus to avoid even a small number of exclusions by having the tools to deal with severe emotional behavioural problems in school, with minimal disruption to other children, is a major outcome in itself, not to mention the associated cost implications of having fewer permanent exclusions.

There is already anecdotal evidence to suggest that the number of exclusions from Thrive trained schools is markedly lower than those that haven’t yet done the training. Although there are still exclusions from these schools, it is now only the most extreme or complex cases that lead to exclusion. A primary reason for this is that Thrive schools are able to better understand behaviour, and the reasons for that behaviour and as well as the tools they then have more capacity, confidence and commitment to work with the more severe cases in a mainstream setting.

Of course many children have already been excluded and some exclusions will always be inevitable. And it is important to recognize the powerful role that Thrive can play in specialist schools as well as mainstream schools. A particular problem for children in this setting is a lack of feelings of safety and security, and implementing Thrive can help make the children feel more safe and secure in their environment.

Over the medium term an increase in feelings of safety can also have an influence on reducing a number of social problems for these young people, many of whom are inherently more vulnerable than most.

Again, the cornerstone of these positive outcomes being derived from Thrive is the influence on feelings of self worth, which is bound up with the development of a sense of self and in turn a sense of reliance and trust in themselves.

In other words, a central theme throughout the outcome trajectory for children is the influence Thrive has on their own self worth and emotional resilience going forward.

Over to you

Reduced anxiety and behavioural incidents. Calmer classrooms filled with engaged leaners. Improved relationships with parents and carers. These are just some of the outcomes reported by settings embedding Thrive’s whole-school approach to mental health and wellbeing. Are you ready to join them? Click here to get started.