Targeted support guide
A guide to help schools and colleges develop effective targeted mental wellbeing support. Created in partnership with and funded by the Department for Education.
A guide to help schools and colleges develop effective targeted mental wellbeing support. Created in partnership with and funded by the Department for Education.
Providing effective school or college-based targeted support for children and young people with mental wellbeing needs can help to improve their attendance and behaviour, their engagement and progress in education, and enable them to fulfil their potential.
This toolkit, made up of the targeted support tool and this guide, will help you to review, plan and embed effective targeted support that meets the specific mental health and wellbeing needs in your school or college.
It is for use by anyone with responsibility for supporting the mental health and wellbeing of children and young people in a school or college.
Download this guide in PDF format.
‘Targeted support’ (sometimes referred to as a ‘targeted support programme’ or ‘targeted intervention’) in this context refers to mental wellbeing support in schools and colleges aimed at specific individuals or groups of students.
It can provide early or preventative support for mental wellbeing needs and forms an important part of a school or college’s graduated response to supporting students to make progress with their learning and wider development.
Reasons for offering targeted mental wellbeing support are wide-ranging. They might include, for example, supporting students to attend or engage in learning, to improve behaviour or wider social or emotional development, or respond to events that may be temporary but can lead to mental health issues, such as bullying or bereavement. Targeted support may help any student, including those identified as having special educational needs.
Targeted support is additional to and distinct from universal support which aims to promote and support the mental wellbeing of all students in a school or college. This includes providing a safe, calm, and inclusive learning environment for all, with a balanced curriculum including RSHE, as well as relevant enrichment activities.
Targeted and universal support for mental wellbeing are both key parts of an effective whole-school or college approach to mental health and wellbeing, supported by a broad evidence base summarised recently by both the NICE evidence reviews and the Education Endowment Fund.
NHS specialist services are not covered in this toolkit. If you suspect a student’s needs are complex and/or severe and need specialist support, you should follow your setting’s graduated response procedures, including liaising with your Mental Health Support Team (where available), and the relevant NHS specialist services and any other appropriate external support to make a referral.
The targeted support tool is an interactive library of targeted support options that schools and colleges might offer, filterable by relevant categories (e.g., educational phase, age, outcomes, delivery method). It is designed to help you to identify forms of evidence-based targeted support to meet the needs of your students that other schools and/or colleges have demonstrated can be effective. The tool outlines forms of targeted support and associated evidence using the most recent evidence reviews published by NICE.
While some forms of targeted support may be facilitated by education staff with relevant training and expertise, other programmes will need to be delivered by fully trained and qualified providers.
Some options are free of charge for a school or college to offer students, while others may be funded through core budgets including pupil premiums, or the flexibilities in the 16-19 additional hours funding.
You may wish to engage your school or college senior leadership team early to confirm support and available resources for reviewing your setting’s approach to targeted support, including funding for any paid programmes.
Education staff are not expected to deliver support that is beyond their expertise and remit and must not diagnose or deliver specialist mental health treatment for students.
It’s important to consider targeted support as part of your setting’s broader pastoral offer and whole-school or college approach to mental health and wellbeing, including as part of broader support through the SEND system for children and young people with special educational needs.
Targeted wellbeing support is most effective when delivered in coordination with other support and activity that wraps around a student, including universal support in school or college and support at home.
This may involve working in partnership with parents and carers, encouraging access to wider extracurricular and community activities and, where appropriate, working with health professionals or other local services.
This section outlines:
There are various types of information that can be drawn on to build up a picture of the mental health and wellbeing need in your school or college.
It can be helpful to consider three types of information:
There are a range of ways of collecting direct information about students’ mental wellbeing. While this information may be collected by relevant staff, you may also wish to liaise with external services where appropriate.
Indirect (or ‘proxy’) indicators of mental health and wellbeing issues can also help to build up a picture of needs in your school or college. Often, it is indirect indicators which first come to light and indicate a need for further exploration and support.
Indirect indicators include things like:
As well as direct and indirect information, it can be helpful to consider risk factors and systemic issues that may make certain students more vulnerable to mental health difficulties.
This might include risk factors associated with specific groups, including children and young people who have experienced trauma, looked-after and previously looked after children, young carers and those identified as having other special educational needs (see statutory definition reproduced in the SEND Code of Practice).
You should also consider the potential impact of factors such as race and ethnicity, gender and sexual orientation, socio-economic factors, as well as any specific challenges in your local area.
Any consideration of these factors should also take account of student voice. Settings should ensure that there are opportunities for students to be listened to, such as student councils, dedicated tutor time and assemblies, and suggestion boxes.
Access resources to support you to enable student voice in your setting.
Having collected information about the range of challenges students face in your setting, it’s important to review your setting’s current provision and consider whether it is effectively meeting your students’ needs.
This can help you to identify any potential gaps or shortfalls. You may also identify elements of your current support that you wish to learn from or develop.
This review should cover the targeted and universal support already in place in your setting. You may also wish to consider:
It’s also crucial to consider what evidence there is about the impact of the existing support you have in place, and whether the mix of support is effectively meeting the various needs of your students.
Once the key needs and the support that is already in place in your setting have been understood, you can use this information to identify priority areas for refreshing and developing your targeted support provision.
You may wish to consider what key factors have changed since your current offer was first established. This can help to identify areas of need where individuals and groups of students may benefit from further or different support. For example, you may identify a cohort of students where there is insufficient support or whose needs are not currently being met, or a current targeted support programme that has not had the intended positive effect.
As well as speaking with students, it is important to liaise with school leadership and other relevant staff, such as SENCOs, college SEND leads, school nurses, and counsellors etc.
This will ensure that your targeted support offer is aligned with your setting’s overall approach to mental health and wellbeing, and has early support across your school or college.
You may wish to use a logic model to help support you to identify priority areas for change.
Understand the mental wellbeing challenges in your school or college
Map the support already available in your setting
Identify gaps and key areas for development as part of your setting’s broader pastoral offer
This section outlines:
Once you have identified priority areas for change as part of your setting’s broader offer, you can use this information to scope and identify forms of targeted support that are appropriate for your setting.
Alongside reviewing the available options in the targeted support tool, you may wish to speak with other professionals about what is available locally to help you to identify appropriate targeted support options.
For example, you may wish to consult with local authority and NHS contacts (including your Mental Health Support Team where in place) to understand what support is available locally. Many local authorities provide resources and promote their local offers on their websites.
It can also be helpful to consult with relevant staff in your school or college, such as educational psychologists, SENCos and designated safeguarding leads, in-school or college counsellors, nurses, and emotional literacy support assistants.
There are some considerations that settings should bear in mind when identifying appropriate targeted support options:
There are several factors to consider when assessing the suitability of a type of support or specific targeted support programme to your setting.
It can be helpful to ensure that:
While you may wish to introduce both individual and group-based targeted support to meet the needs of different students in your setting, it’s important to bear in mind the differences, benefits and challenges that come with each.
It can be helpful to reflect on:
When deciding on the type of support provided, it is also important to be sensitive to students’ perspectives and preferences, which may differ across settings.
For example, some students may find it difficult to share their experiences in groups, while others may benefit from hearing from others.
Depending on the nature of the programmes you choose, they may be delivered by internal or external staff. Some things to consider include:
1. The role of education staff
School and college staff must not diagnose mental health conditions or carry out mental health interventions.
Some forms of targeted pastoral support may be facilitated by school or college staff (and sometimes with the support of students, e.g., peer mentoring). This will depend on the nature of the targeted support, and the expertise and capacity of your setting’s staff.
For example, some targeted support that may be appropriate for a whole class may be delivered or supported by relevant staff (e.g., a mindfulness programme delivered in tutor time).
Relevant school or college staff who might provide support include mental health leads, mental health first aiders, SENCos, SEND leads, school or college nurses, educational psychologists, learning mentors, emotional literacy support assistants, and other relevant trained staff.
2. Working with external providers
Some forms of targeted support will require working with external specialists e.g., suitably qualified counsellors, or Mental Health Support Teams. This may be the case when a targeted support programme requires specialist training and expertise to deliver, is of a sustained duration or intensity, or is outside the remit and expertise of the staff in your setting.
Working with external providers can help to reduce the burden on internal staff and ensure that staff are not carrying out duties beyond their role, training and expertise.
The capacity of internal staff to work with and liaise with external providers should also be considered, alongside consideration of the potential costs likely to be incurred over the duration of any programme.
3. Working with the right external provider(s)
If you do work with an external provider, it’s important to ensure that they are properly qualified and experienced to provide their services, and to follow your school or college’s safeguarding procedures at all times.
You should ask non-NHS service providers to share their credentials, explain their experience, the evidence base for their methods, explain how the programme would be delivered and accessed, and be clear on the standards of service and level of quality assurance offered.
The British Association for Counselling and Psychotherapy provides guidance on working with counsellors in schools and colleges, including the qualifications and competencies any counsellor should demonstrate.
There should be a ‘safe space’ available for the delivery of any targeted support (either for groups or individuals). It’s important to ensure that:
Some targeted support programmes may also be delivered online. Settings should ensure that there is a separate space available for this to be delivered.
You can use the targeted support tool to review and identify types of targeted support that may be appropriate to your setting. All of the support options can be filtered by the outcomes you hope to achieve and improve, the delivery method, and who the programmes will be delivered by (internal or external). Some options also contain information on specific programmes that have been evaluated as part of the NICE evidence reviews, and that you may wish to explore further to see if they are appropriate for your setting.
The Early Intervention Foundation’s EIF Guidebook catalogues a range of other intervention programmes that have separately been evaluated and shown to improve outcomes for children and young people. You may wish to explore one or several types of targeted support programme to meet the different needs of individuals and groups of students in your setting and to complement any support already in place.
Consider the suitability and logistics of targeted support programmes - including how and where they will be delivered
Identify if targeted support will be delivered by an external provider and consider what this would entail
Review the targeted support options on the targeted support tool and identify programmes that meet the needs of your setting
This section outlines:
Once you have identified and confirmed the targeted support options that are right for your school or college, you should work with relevant leaders and other colleagues in your setting to plan how you will embed them alongside other provision and enable students access to the support.
It’s important to ensure that all staff are aware of any upcoming changes and available programmes and that these are properly signposted to in your setting.
Teaching staff should also be made aware of when students may need to be absent from class to attend a specific programme.
How targeted support programmes are introduced to students will play a crucial role in whether they want to take part.
It can be helpful for a member of school or college staff to introduce students to the support programme, regardless of whether it will be delivered by an external specialist.
If an external specialist will be delivering the support, it can be helpful to emphasise the expertise of the specialist to students.
It can also be helpful to:
It is best to ensure that students themselves are motivated to engage with the programme, rather than participating because someone else (e.g., a teacher, parent or carer) told them that they should. In cases where participation isn’t optional, settings should make this clear to students at the outset.
It may also be appropriate for students to self-refer. For instance, self-referral may be appropriate for older students (post-16).
It is important to inform parents and carers of any targeted support programmes in your setting. Working with parents and carers can also help you to develop a more holistic picture of your students’ wellbeing, and to inform your setting’s wellbeing strategy and offer.
It can be helpful to provide an explanation of how the targeted support works, its intended aims, and how their child may participate. It can also be helpful for a relevant staff member to be available to respond to any questions or concerns that parents and carers have about the support programmes.
When introducing targeted support programmes in your setting, it’s important that the evidence-based targeted support model of each programme is followed as closely as possible.
This is because the research only demonstrates effectiveness within certain parameters. Some support can also be harmful or ineffective if used inappropriately. Parameters may include:
Following the delivery model correctly can also ensure that programmes can be effectively monitored and evaluated.
Develop plans to embed programmes alongside other provision and ensure staff and students are aware of support options
Introduce targeted support programmes to students and encourage relevant individuals and cohorts to participate
Ensure that the evidence-based models are followed for each individual programme
This section outlines:
It is important that targeted support programmes are monitored and evaluated as part of your broader mental health and wellbeing offer. This can help you to understand whether they are working and meeting the needs of students, and to ensure that they are not counterproductive.
Evaluating targeted support can also help to:
It is important to establish from the outset how a targeted support programme will be monitored and evaluated.
There are different ways of evaluating the success of targeted support programmes.
Commonly, young people will be asked to complete a survey or ‘outcome measures’ at the start of the programme (e.g., which measures levels of anxiety or depression), and at the end. This allows those evaluating the programme to discern if there has been an improvement.
External providers should provide monitoring and evaluation as part of their offer. When purchasing a targeted support programme from an external provider, you should confirm how they plan to monitor and evaluate the targeted support, and how they will communicate this information to you.
Targeted support programmes designed to be facilitated by relevant internal staff should provide guidance and tools for how to do this.
For further information about evaluation methods and tools, you may wish to consult the following resources from Anna Freud:
While specific targeted support programmes should be monitored and evaluated, this should be within the context of continuously reviewing and refining your setting’s broader pastoral offer.
For example, evaluation may reveal that a universal support programme is improving outcomes for one specific cohort, which might be best served via specific targeted support; or that a targeted support programme may only be effective for students within a certain age range.
Settings should draw on this feedback to iterate and refine their offer to ensure that it is effectively meeting evolving need. This may include regular check-ins and review milestones with senior leadership teams, as well as engaging with parents, carers, and local services.
With an expanding range of evidence-based targeted support options available, settings are encouraged to revisit this toolkit on an ongoing basis.
This can ensure that settings are able to update and tailor their offer and provide the best support possible as part of a whole-school or college approach to mental health and wellbeing.
Establish how targeted support programmes will be monitored and evaluated
If working with an external provider, confirm how they will monitor and evaluate their service, and how they will communicate this to you
Ensure there are checkpoints to review evaluation data, and a strategy in place to refine your offer in response to this feedback
Use the designated filters to find targeted support options that will suit your students' needs.
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