‘‘Working Things OutWorking Things Out’’ - -

an evidence-based programmean evidence-based programme

to engage young people.to engage young people.

Carol FitzpatrickCarol Fitzpatrick

& WTO team& WTO team

Working Things Out TeamWorking Things Out Team

Eileen Brosnan, Diane Beattie, John Sharry, Deirdre Cleary, Lorna Power, Mike Power, Andrea Conlon, Martha Noone & Suzanne Guerin.

SPHE Support Service Dept. of Education

Working Things Out DVDWorking Things Out DVD

• 15 stories made by young people who 15 stories made by young people who have coped with mental health difficultieshave coped with mental health difficulties

• Own voicesOwn voices

• Own wordsOwn words

• Strengths basedStrengths based

Working with individual Working with individual young peopleyoung people

• Low keyLow key

• Engage as ( reluctant ) consumerEngage as ( reluctant ) consumer

• ‘‘Interested in your views on this’Interested in your views on this’

• Third person questionsThird person questions

• Facilitator positionFacilitator position

Working Things Out Adolescent Working Things Out Adolescent Group ProgrammeGroup Programme

An 8 week CBT based programmeAn 8 week CBT based programme

Aims: Aims:

• to reduce depressive symptomsto reduce depressive symptoms• improve coping skillsimprove coping skills• improve general functioningimprove general functioning• decrease emotional and behavioural decrease emotional and behavioural

symptoms symptoms • to make progress in overcoming challenges to make progress in overcoming challenges

and reaching goals.and reaching goals.

EvaluationEvaluation

Participants:Participants:

Adolescents newly referred to Mater Adolescents newly referred to Mater CAMHSCAMHS

Method: Method:

Random allocation to WTO group or Random allocation to WTO group or TAUTAU

MeasuresMeasures

• Kiddie-SADS-PL (Kaufman et al., 1996) • Strengths & Difficulties Questionnaire (Goodman, 1997) – both

parent report and adolescent report• Adolescent Coping Scale (Frydenberg & Lewis, 1993)• Reynolds Adolescent Depression Scale, Version 2 (Reynolds,

2002)• Challenges and Goals Forms (Sharry et al., 2005) – rated by

both parent and adolescent• General Health Questionnaire (Goldberg, 1978) – completed by

parent• Clinical Global Impressions Scale (Guy, 1976)• Children’s Global Assessment Scale (Shaffer et al., 1983)

ResultsResults

WTO group: WTO group:

N = 33, Mean age: 14.2N = 33, Mean age: 14.2

M:F 17:16 No. of sessions 6.4M:F 17:16 No. of sessions 6.4

TAU group:TAU group:

N = 34, Mean age: 13.9N = 34, Mean age: 13.9

M:F 19:15 No. of sessions 5M:F 19:15 No. of sessions 5

ResultsResults

Adolescent Coping Scale:Adolescent Coping Scale:Sig. improvement in + coping in WTO group, not in TAU Sig. improvement in + coping in WTO group, not in TAU

groupgroup

Adolescent SDQ Total Problem Score:Adolescent SDQ Total Problem Score:No significant change in either group.No significant change in either group.

Adolescent SDQ Pro-social scale:Adolescent SDQ Pro-social scale:Sig. improvement in WTO group, not in TAU group; Sig. improvement in WTO group, not in TAU group;

improvement significantly related to male genderimprovement significantly related to male gender

ResultsResults

Parent SDQ Total Problem Score:Parent SDQ Total Problem Score:

Improvement in both groups, not sig.Improvement in both groups, not sig.

Reynolds Depression Scale:Reynolds Depression Scale:

No change in either group.No change in either group.

CGAS:CGAS:

Significant improvement in both groups, no difference.Significant improvement in both groups, no difference.

Working Things Out through SPHE

EvaluationEvaluation

Aims: Aims:

• To determine if students participating in ‘enhanced SPHE’ had better outcomes in terms of help-seeking, emotional and behavioural difficulties, and view of school ethos.

MeasuresMeasures

• Strengths & Difficulties Questionnaire (Goodman, 1997)

adolescent report

• Children’s Coping Strategies Checklist (Ayers & Sandler, 1996 )measures coping strategies in 4 domains: support seeking, avoidance, active coping, distraction.

• ‘Getting Help for Personal Problems’

• ‘What is your school like’ ( School Ethos )

EvaluationEvaluation

Participants Participants

Second year students in17 post-primary Second year students in17 post-primary schoolsschools

MethodMethod

Random allocation by class group to routine Random allocation by class group to routine SPHE or enhanced SPHESPHE or enhanced SPHE

ResultsResults

1080 students participated at T11080 students participated at T1

Data available at T1, T2, and T3 for 785 ( 73%)Data available at T1, T2, and T3 for 785 ( 73%)

Non-completers were younger, with significantly Non-completers were younger, with significantly higher scores on SDQ conduct problems, total higher scores on SDQ conduct problems, total problems, and lower pro-social behaviour, and problems, and lower pro-social behaviour, and lower active coping strategies.lower active coping strategies.

ResultsResults

178 students ( 23%) scored 16 or > on SDQ Total 178 students ( 23%) scored 16 or > on SDQ Total Problems Score indicating being ‘at risk’. Problems Score indicating being ‘at risk’.

Equally divided between RP and EPEqually divided between RP and EP

SDQ - Total Difficulties

14

16

18

20

22

Time 1 Time 2 Time 3

Time

SD

Q S

co

reMale Control

Male Enhanced

Female Control

FemaleEnhanced

SDQ Hyperactivitity

4

4.5

5

5.5

6

6.5

7

7.5

8

Time 1 Time 2 Time 3

Time

SD

Q S

co

re

Male Control

Male Enhanced

Female Control

FemaleEnhanced

ConclusionsConclusions

• Working Things Out Stories are useful for engaging

adolescents

• Working Things Out Adolescent Group Programme benefits adolescent coping, and may improve pro-social behaviour in males

• Working Things Out through SPHE may specifically benefit ‘at risk’ adolescent males

AcknowledgementsAcknowledgementsThe young people and their parents who participated

Funders:Health Research Board

Mater FoundationESB ElectricAidNorthern Area Health BoardThe National Suicide Review GroupParents Plus