Claire Parker

There has been recent emphasis on the assessment of competence in psychotherapy training courses to improve evidence‐based practice and outcomes for clients. The Systemic Practice Scale (SPS) was developed as a structured way of evaluating systemic practice. There is, however, little research on the impact and experience of competence measures, particularly in the context of systemic practice. Five focus groups conducted with sixteen students and seven supervisors from systemic family practice (SFP) programmes explored their views of the SPS as an appropriate measure of systemic competence. Data was analysed using a discourse analysis with three dominant discourses identified:feedback as valuable but uncomfortable;measuring competence; andbeing systemic. The SPS was viewed as a valuable and useful measure of systemic competence when reflexivity and collaboration is maintained between the student and supervisor.Practitioner points: There is limited research exploring the use of competence measures in systemic practice The SPS was perceived as broadening perspectives of students’ practice and competence, reiterating the importance of feedback in a collaborative supervisory relationship Increasingly the SPS is being used across clinical psychotherapy training courses (including systemic IAPT course and Doctorate of Clinical Psychology) It has the potential to be used more widely with wider implications for the development of systemic training standards in systemic practice

Background: There is limited research that explores the association between exclusion from school and mental health, but it seems intuitively plausible that the recognition of mental difficulties by key teachers and parents would influence the likelihood of exclusion from school.Methods: A secondary analysis of the British Child and Adolescent Mental Health survey 2004, (n = 7997) and the 2007 follow-up (n = 5326) was conducted. Recognition of difficulty was assessed via a derived variable that combined the first item of the Impact supplement of the Strengths and Difficulties Questionnaire which asked parents and teachers if they thought that the child has difficulties with emotions, behaviour and concentration, and the presence/absence of psychiatric disorder measured by the Development and Well-being Assessment.Results: Adjusted logistic regression models demonstrated that children with recognised difficulties were more likely to be excluded [adjusted odds ratio (OR) 5.78, confidence interval 3.45–9.64, p < 0.001], but children with unrecognised difficulties [adjusted OR 3.58 (1.46–8.81) p < 0.005] or recognised subclinical difficulties [adjusted OR 3.42 (2.04–5.73) p < 0.001] were also more likely to be excluded than children with no difficulties. Children with conduct disorder and attention deficit hyperactivity disorder were most likely to be excluded compared with other types of disorder.Conclusion: Exclusion from school may result from a failure to provide timely and effective support rather than a failure to recognise psychopathology.

Background: Exclusion from school is increasingly recognized as pertinent to child health. National educational data reveal that boys, children who are looked‐after, living in poverty, have special educational needs, or from certain ethnic minorities, are disproportionately excluded from school. As population‐based data on the wider characteristics of excluded children are scarce, we aimed to describe predictors of school exclusion in the Avon Longitudinal Study of Parents and Children.Method: Avon Longitudinal Study of Parents and Children, a prospective U.K. population‐based birth cohort study, collected parent reports of permanent school exclusions by 8 years and parent and self‐reports of permanent and fixed‐term exclusions in the preceding 12 months at 16 years. Potential risk factors were examined for associations with exclusion using logistic regression, with a focus on child mental health and neurodevelopment.Results: Analyses were based on all available data on 53/8,245 (0.6%) pupils excluded from school by 8 years and 390/4,482 (8.7%) at 16 years. Key factors associated with exclusion at both time points included male gender, lower socio‐economic status, maternal psychopathology, mental health and behavioural difficulties, psychiatric disorder, social communication difficulties, language difficulties, antisocial activities, bullying/being bulled, lower parental engagement with education, low school engagement, poor relationship with teacher, low educational attainment, and special educational needs (all p < .05).Conclusion: Exclusion from school was associated with child, family and school‐related factors identifiable at, or prior to, primary school age. Child health professionals have an important role in the holistic, multidisciplinary assessment of children who are at risk of exclusion from school. Mental health and neurodevelopmental difficulties should be recognized and supported, to improve the health and educational outcomes among this vulnerable group.

Background: Children with poor mental health often struggle at school. The relationship between childhood psychiatric disorder and exclusion from school has not been frequently studied, but both are associated with poor adult outcomes. We undertook a secondary analysis of the British Child and Adolescent Mental Health Surveys from 2004 and its follow-up in 2007 to explore the relationship between exclusion from school and psychopathology. We predicted poorer mental health among those excluded.Method: Psychopathology was measured using the Strengths and Difficulties Questionnaire, while psychiatric disorder was assessed using the Development and Well-Being Assessment and applying Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) criteria. Exclusion from school and socio-demographic characteristics were reported by parents. Multi-variable regression models were used to examine the impact of individual factors on exclusion from school or psychological distress.Results: Exclusion from school was commoner among boys, secondary school pupils and those living in socio-economically deprived circumstances. Poor general health and learning disability among children and poor parental mental health were also associated with exclusion. There were consistently high levels of psychological distress among those who had experienced exclusion at baseline and follow-up.Conclusions: We detected a bi-directional association between psychological distress and exclusion. Efforts to identify and support children who struggle with school may therefore prevent both future exclusion and future psychiatric disorder.

There is a growing focus on child wellbeing and happiness in schools, but we lack self-report measures for very young children. Three samples (N = 2345) were combined to assess the psychometric properties of the How I Feel About My School (HIFAMS) questionnaire, which was designed for children aged 4–8 years. Test–retest reliability was moderate (intraclass correlation coefficient = .62). HIFAMS assessed a single concept and had moderate internal consistency (Cronbach’s alpha values from .62 to .67). There were low correlations between scores on the child-reported HIFAMS and parent and teacher reports. Children at risk of exclusion had significantly lower HIFAMS scores than the community sample (mean difference = 2.4; 95% confidence interval (CI) = [1.6, 3.2]; p < .001). Schools contributed only 4.5% of the variability in HIFAMS score, the remaining 95.5% reflecting pupil differences within schools. Girls’ scores were 0.37 units (95% CI = [0.16, 0.57]; p < .001) higher than boys, while year group and deprivation did not predict HIFAMS score. HIFAMS is a promising measure that demonstrates moderate reliability and discriminates between groups even among very young children.

Purpose: – The purpose of this paper is to explore the association between children who are at risk of being or who have been excluded from school between the ages of 4 and 12 years and the role of psychopathology, development and attainment. Design/methodology/approach: – A case-control approach was conducted. Cases were children who had been excluded from school compared to those who had no reported exclusions and normative data where possible. A range of measures were used to collect information from the parent, child and teacher on areas covering the child’s mental health and well-being. Findings: – The findings showed the number of difficulties faced by children who are at risk of being or who have been excluded from school compared to gender- and age-matched controls and normative data increased. Behavioural difficulties were apparent in the majority of the cases and an alarming number of children reported self-harm. Interestingly nearly all the cases had recognised needs, but not all of them were accessing appropriate services. Practical implications: – There have been a number of changes regarding the identification and support of children’s mental health and well-being. This study highlights gaps in resources and provision, particularly around behavioural difficulties for children who are presenting as not coping in school. Originality/value: – The findings from the SKIP study indicate the complexities and compounded difficulties faced by children who are experiencing exclusion from school. By implementing a systematic group of assessments the study was able to identify these complexities of need across a vulnerable group of children.

(2016). Emotional and behavioural difficulties and mental (ill)health. Emotional and Behavioural Difficulties: Vol. 21, Emotional and behavioural difficulties and mental (ill)health, pp. 1-7.

Exclusion from school is associated with adverse outcomes for young people. There is limited research that explores parents’ perspectives, particularly in relation to the exclusion of primary school aged children. The present study used semi-structured interviews with 35 parents of 37 children aged 5–12 years from the Southwest of England. Parents experiences were captured in a conceptual model through three main themes. Exclusion was described as part of a complex journey of difficulties reflected by a continuum of coping. The child’s place on the continuum was determined by an interaction between the child, family, and school with communication a key determinant. The study also highlighted the wider implications of exclusion, including emotional and functional impacts on the child and parent and highlighted the importance of the parents voice in the identification and support of their child’s needs. It also presents many complexities surrounding exclusion from school and limited support parents felt their child was offered.

Childhood psychiatric disorders are associated with a wide range of adverse outcomes including poor academic attainment. For some children these difficulties are recognised through school Special Educational Need procedures (SEN) but many others may remain unidentified and/or unsupported. In Britain, government data suggests disproportionate representation of children with a SEN among children permanently excluded from school. This review asks whether school-aged children with impairing psychopathology were more likely to be excluded from school than those without. Databases covering education, social sciences, psychology and medicine were searched, experts were contacted and bibliographies of key papers were hand-searched. Studies were included if the population covered school-aged children, and if validated diagnostic measures had been used to assess psychopathology. Children with impairing psychopathology had greater odds of exclusion compared to the rest of the school-age population: odds ratios range from 1.13 (95% CI: 0.55–2.33) to 45.6 (95% CI: 3.8–21.3). These findings however need to be considered in light of the paucity of the literature and methodological weaknesses discussed.

When children with special educational needs are excluded from school, it should raise the concern that these children are not receiving adequate help and support. This systematic review aims to identify the prevalence of psychiatric disorder or impairing psychopathology among children who are excluded from school compared to children who are not excluded from school. The review follows the guidelines set out by the Centre of Research and Dissemination ( Centre for Reviews and Dissemination, 2009 ). We used broad search terms (across 16 databases) in order to avoid missing papers, our initial screening stage involved 3712 titles and abstracts. Five studies finally met our inclusion criteria. The results from these studies suggest that the odds of children who have been excluded from school having some kind of impairing psychological or behavioural impairment is increased in comparison to children who have not been excluded (odds ratios ranging from 1.13–31.9). However, the paucity of primary research in this area, combined with methodological weaknesses in the identified studies makes it difficult to draw firm conclusions. The need for education and mental health professionals to work together to provide the appropriate support for all children at risk of exclusion is of great and immediate concern.