Publications by category
Journal articles
Owens, Hansford L, Sharkey S, Ford T (In Press). Needs and fears of young people presenting at Accident & Emergency department following an act of self-harm: Secondary analysis of qualitative data.
British Journal of PsychiatryAbstract:
Needs and fears of young people presenting at Accident & Emergency department following an act of self-harm: Secondary analysis of qualitative data.
Background:
Presentation at an Accident and Emergency (A&E) department is a key opportunity to engage with a young person who self-harms. The needs of this vulnerable group and their fears about presenting to healthcare services, including A&E, are poorly understood.
Aims:
To examine young people’s perceptions of A&E treatment following self-harm and their views on what constitutes a positive clinical encounter.
Method:
Secondary analysis of qualitative data from an experimental online discussion forum. Threads selected for secondary analysis represent the views of 31 young people aged 16-25 with experience of self-harm.
Results:
Participants reported avoiding A&E whenever possible, based on their own and others’ previous poor experiences. When forced to seek emergency care, they did so with feelings of shame and unworthiness. These feelings were reinforced when they received what they perceived as punitive treatment from A&E staff, perpetuating a cycle of shame, avoidance and further self-harm. Positive encounters were those in which they received ‘treatment as usual’, i.e. non-discriminatory care, delivered with kindness, which had the potential to challenge negative self-evaluation and break the cycle.
Conclusions:
The clinical needs of young people who self-harm continue to demand urgent attention. Further hypothesis testing and trials of different models of care delivery for this vulnerable group are warranted.
Abstract.
Allen K, Hansford L, Hayes R, Longdon B, Price A, Byford S, Norwich B, Ford T (In Press). Teachers’ views on the acceptability and implementation of the Incredible Years ® Teacher Classroom Management programme in English (UK) primary schools from the STARS trial.
British Journal of Educational PsychologyAbstract:
Teachers’ views on the acceptability and implementation of the Incredible Years ® Teacher Classroom Management programme in English (UK) primary schools from the STARS trial
Background
The Incredible Years® (IY) Teacher Classroom Management (TCM) programme may reduce disruptive behaviour in the classroom and improve child and teacher mental health, however few studies have considered how acceptable TCM is to teachers or what facilitators and barriers there are to its implementation.
Aims
In this paper we examine the acceptability of the full six-day TCM programme and teachers’ perceived barriers and facilitators to implementation in the English (UK) primary school context.
Sample
Forty-four English (UK) primary school teachers who attended the TCM programme as part of the STARS trial.
Methods
We completed focus groups and telephone interviews with participating teachers two months after they completed the TCM programme. Thematic analysis was used to examine the data, and a framework approach was applied to organise and summarise themes.
Results
Teachers liked the structure of the course, the peer group learning environment, delivery methods, and the opportunity to reflect outside the classroom on their practice. They reported that the video clips used lacked cultural relevance and highlighted the importance of group leadership style. Perceived facilitators to implementation included an understanding of the theory underpinning TCM and adaptability of the TCM strategies. Barriers included perceived gaps in the course content in relation to challenging behaviour, applying strategies with older children and the school context within which teachers were working.
Conclusion
Our findings suggest high levels of acceptability to TCM overall, but also highlight the need for a whole school approach to combat potential barriers to implementation.
Abstract.
Thomas F, Wyatt K, Hansford L (In Press). The violence of narrative: embodying responsibility for poverty-related distress. Sociology of Health and Illness: a journal of medical sociology
Hansford L, Thomas F, Wyatt K (2022). How does housing affect end-of-life care and bereavement in low-income communities? a qualitative study of the experiences of bereaved individuals and service providers in the United Kingdom.
Palliative Care and Social Practice,
16Abstract:
How does housing affect end-of-life care and bereavement in low-income communities? a qualitative study of the experiences of bereaved individuals and service providers in the United Kingdom
Background: Access to affordable, appropriate housing is one of the key social determinants of health, affecting well-being across the lifecourse. However, beyond a recognition that housing quality is linked to place of death, little is known about the ways in which housing status impacts social, emotional, and practical aspects of dying and bereavement. Method: the Checking Out project is a qualitative study aiming to explore the ways in which socio-economic status impacts people’s experiences of, and attitudes towards, death, dying, and bereavement in the United Kingdom. Qualitative interviews were carried out with 14 bereaved individuals with experience of poverty at end of life or in bereavement, and 15 professionals supporting individuals in low-income communities. Interviews were conducted via phone/video call, and data include experiences of end of life and bereavement both before and during the pandemic. Transcripts were examined using thematic analysis. Results: Housing emerged as an important factor affecting people’s experiences, with 7 of the 14 bereaved individuals and all except 1 of the professionals discussing housing-related issues. Participants described ways in which unsuitable housing and housing insecurity impacted practical aspects of dying but also emotional and social well-being at end of life. Housing-related issues affected both patients and their families, though families found it difficult to air these concerns when their relative was dying. Conclusion: the paper demonstrates how trusted professionals are able to advocate or address the issues faced by bereaved individuals and suggests implications for policy and practice. A greater awareness of the potential impact of housing status across public services, including healthcare practitioners, welfare support, and housing providers, could better support patients and practitioners to address these issues proactively. Housing providers and policy-makers should be included as key partners in collaborative public health approaches to palliative care.
Abstract.
Hansford L, Thomas F, Wyatt K (2022). Poverty, choice and dying in the UK: a call to examine whether public health approaches to palliative care address the needs of low-income communities. Mortality, 1-17.
Thomas F, Hansford L, Wyatt K, Byng R, Coombes K, Finch J, Finnerty K, Ford J, Guppy K, Guppy R, et al (2020). An engaged approach to exploring issues around poverty and mental health: a reflective evaluation of the research process from researchers and community partners involved in the DeStress study. Health Expectations, 24(S1), 113-121.
Thomas F, Hansford L, Ford J, Wyatt K, McCabe R, Byng R (2019). How accessible and acceptable are current GP referral mechanisms for IAPT for low-income patients? Lay and primary care perspectives. Journal of Mental Health, 29(6), 706-711.
(2019). Practical Justice: Principles, Practice and Social Change.
Allen KL, Hansford L, Hayes R, Allwood M, Byford S, Longdon B, Price A, Ford T (2019). Teachers’ perceptions of the impact of the Incredible Years® Teacher Classroom Management programme on their practice and on the social and emotional development of their pupils.
British Journal of Educational PsychologyAbstract:
Teachers’ perceptions of the impact of the Incredible Years® Teacher Classroom Management programme on their practice and on the social and emotional development of their pupils
Background
The Incredible Years® (IY) Teacher Classroom Management (TCM) programme may be an effective way to reduce teacher stress levels, improve child behaviour and promote positive socio-emotional development. However, few studies have considered what teachers think of the course and how it might work.
Aims
In this paper we examine teachers’ perceptions of the impact of the TCM programme and how it might work in the classroom.
Sample(s)
Fourty-four UK primary school teachers who attended the TCM programme as part of the STARS trial (Ford et al. 2018).
Methods
Focus groups and interviews were held with teachers two months after completing the TCM programme. Thematic analysis (Braun & Clarke, 2006) was employed to explore the subsequent data.
Results
Three main themes were identified: impact on the teacher; on children; and on parent-teacher relationships. Impact on the teacher included a positive change in their ethos. Teachers reported being more able to see things from the child’s perspective, placing a greater focus on building positive relationships, thinking before responding, feeling calmer, more confident and in control and employing strategies to create positive interactions with children. Teachers felt this had had a positive impact on their pupils’ development and relationships with parents. Feedback on whether or not TCM was effective in tackling particularly challenging behaviour was more mixed.
Conclusions
Our findings suggest that teachers experience the TCM programme as beneficial. This is discussed alongside other qualitative and quantitative studies in this field.
Abstract.
Hayes RA, Titheradge D, Allen K, Allwood M, Byford S, Edwards V, Hansford L, Longdon B, Norman S, Norwich B, et al (2019). The Incredible Years® Teacher Classroom Management programme and its impact on teachers’ professional self-efficacy, work related stress and general well-being: results from the STARS randomised controlled trial.
Journal of Educational PsychologyAbstract:
The Incredible Years® Teacher Classroom Management programme and its impact on teachers’ professional self-efficacy, work related stress and general well-being: results from the STARS randomised controlled trial
Background
Teaching is a stressful occupation with poor retention. The Incredible Years® Teacher Classroom Management (TCM) programme is a training program that past research has demonstrated may be an effective intervention for children’s mental health, but little research has explored any impacts there may be on the teachers’ own professional confidence and mental health.
Aims
In this paper we evaluate whether TCM may lead to changes in teachers’ wellbeing, namely a reduction in burnout and an improvement in self-efficacy and mental health.
Sample
Eighty schools across the South West of England were recruited between September 2012 and September 2014. Headteachers were asked to nominate one class teacher to take part.
Methods
Eighty teachers were randomised to either attend a TCM course (intervention) or not (control). TCM was delivered to groups of up to twelve teachers in six whole-day workshops that were evenly spread between October and April. At baseline and nine months follow-up we measured teachers’ mental health using the Everyday Feelings Questionnaire (EFQ), burnout using the Maslach Burnout Inventory-General Survey (MBI-GS) and self-efficacy using the Teachers’ Sense of Efficacy Scale-Short (TSES-Short).
Results
Using linear regression models there was little evidence of differences at follow-up between the intervention and control teachers on the outcomes (the smallest p-value was 0.09).
Conclusions
Our findings did not replicate previous research that TCM improved teachers’ sense of efficacy. However, there were limitations with this study including low sample size.
Abstract.
Hansford L, Thomas F, Wyatt K (2019). The impact of the Work Capability Assessment on mental health: claimants’ lived experiences and GP perspectives in low-income communities.
Journal of Poverty and Social Justice,
27(3), 351-368.
Abstract:
The impact of the Work Capability Assessment on mental health: claimants’ lived experiences and GP perspectives in low-income communities
This paper examines the impact of increased welfare conditionality on people with mental health issues claiming benefits in the UK. Drawing on data from the DeStress study, this paper explores the lived experience of welfare claimants in low-income communities, and the perspectives of GPs seeking to support them. Particular focus is placed on people’s experience of the Work Capability Assessment, the tool used to determine welfare claimants’ entitlement to sickness benefit, and how the narratives and culture surrounding welfare reform and the actual assessment itself can have a negative impact on mental health and wellbeing.
Abstract.
Ford T, Hayes RA, Edwards V, Logan GS, Norwich B, Allen KL, Hansford L, Longdon BM, Norman S, Price A, et al (2019). Training teachers in classroom management to improve mental health in primary school children: the STARS cluster RCT. Public Health Research, 7
Thomas F, Hansford L, Ford J, Wyatt K, McCabe R, Byng R (2018). Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform.
Palgrave Communications,
4Abstract:
Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform
Associations between mental health and poverty are increasingly well established. Yet in neoliberally oriented contexts in which distress engendered through the everyday hardships of poverty is increasingly pathologised and medicalised, important questions are raised over the assumptions inherent within mental health policy and its implementation. Using the UK as a focus, this paper reviews and maps out key questions that require investigation in order to better understand the complex inter-relations between poverty and distress; explores how current paradigms might influence notions of individual responsibility and agency as well as health seeking behaviours; and examines the role of, and cultural and systemic expectations and constraints placed upon GPs as they respond to distress amongst patients from low-income communities. In so doing, we argue for recognition of the moral narratives that underpin both mental health care and processes of welfare reform, and call for an expansion of conventional notions of evidence-based healthcare to incorporate the understandings, experiences and priorities of people from low-income groups. We call for more detailed questioning and analysis of the interactions that lead to mental health diagnosis and treatment and better understanding of the relevance and effectiveness of current treatment options. As a central tenet of this, we argue for more flexible and nuanced healthcare responses that better reflect the dynamic and multi-faceted nature of poverty-related distress.
Abstract.
Thomas F, Hansford L, Ford J, Wyatt K, McCabe R, Byng R (2018). Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform. Palgrave Communications, 4
Titheradge D, Hayes R, Longdon B, Allen K, Price A, Hansford L, Nye E, Ukoumunne O, Byford S, Norwich B, et al (2018). Psychological distress amongst primary school teachers: a comparison with clinical and population samples. Public Health, 166, 53-56.
Ford T, Hayes RA, Byford S, Edwards V, Fletcher M, Logan G, Norwich B, Pritchard W, Allen K, Allwood M, et al (2018). The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial.
Psychological MedicineAbstract:
The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial
Abstract
Background. We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools’ important influence on child mental health.
Methods. A two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers
in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the
outcomes. Trial registration: ISRCTN84130388.
Results. Eighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (S.D.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference
= −1.0; 95% CI−1.9 to −0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori
subgroup analyses suggested TCM is more effective for children with poor mental health.
Conclusions. TCM provided a small, short-term improvement to children’s mental health particularly for children who are already struggling.
Abstract.
Nye E, Gardner F, Hansford L, Edwards V, Hayes R, Ford T (2015). Classroom behaviour management strategies in response to problematic behaviours of primary school children with special educational needs: views of special educational needs coordinators.
Emotional and Behavioural Difficulties, 1-18.
Abstract:
Classroom behaviour management strategies in response to problematic behaviours of primary school children with special educational needs: views of special educational needs coordinators
© 2015 SEBDA Children identified with special educational needs (SEN) and behavioural difficulties present extra challenges to educators and require additional supports in school. This paper presents views from special educational needs coordinators (SENCos) on various strategies used by educators to support children identified with SEN and problematic behaviours. The data were collected from telephone interviews with six SENCos from the UK’s South West Peninsula. The SENCos were invited to participate because their school was participating in a cluster-randomised trial of a teacher classroom management course (Incredible Years). Using thematic analysis to analyse the data, this paper illustrates strategies deemed by SENCos to be successful in the support of children identified with SEN. The management strategies generated by participating SENCos were then mapped onto those taught as part of the classroom management course for comparison. Findings indicate that strategies from the training programme appear to be appropriate for children identified with both SEN and behavioural difficulties.
Abstract.
Hansford L (2015). Review of 'The SAGE handbook of child research'.
CHILD AND ADOLESCENT MENTAL HEALTH,
20(2), 126-126.
Author URL.
Marlow R, Hansford L, Edwards V, Ukoumunne O, Norman S, Ingarfield S, Sharkey S, Logan S, Ford T (2015). Teaching classroom management – a potential public health intervention?.
Health Education,
115(3-4), 230-248.
Abstract:
Teaching classroom management – a potential public health intervention?
Purpose – the purpose of this paper is to explore the feasibility of a classroom management course as a public health intervention. Improved socio-emotional skills may boost children’s developmental and academic trajectory, while the costs of behaviour problems are enormous for schools with considerable impact on others’ well-being. Design/methodology/approach – in total, 40 teachers attended the Incredible Years (IY) Teacher Classroom Management (TCM) intervention in groups of ten. Afterwards teachers attended focus groups and semi-structured interviews were completed with headteachers to explore whether TCM was feasible, relevant and useful, research processes were acceptable and if it influenced teachers’ practice and pupils. Teachers completed standardised questionnaires about their professional self-efficacy, burnout and well-being before and after attendance. Findings – in all, 37/40 teachers completed the course. Teachers valued sharing experiences, the support of colleagues in the group and time out to reflect on practice and rehearse new techniques. Most teachers reported that they applied the strategies with good effect in their classrooms. Teachers’ questionnaires suggested an improvement in their self-efficacy in relation to classroom management (p=0.03); other scales changed in the predicted direction but did not reach statistical significance. Research limitations/implications – Although preliminary and small, these feasibility study findings suggest that it was worthwhile proceeding to a definitive randomised controlled trial (RCT). Practical implications – Should the RCT demonstrate effectiveness, then the intervention is an obvious candidate for implementation as a whole school approach. Originality/value – Successful intervention with one teacher potentially benefits every child that they subsequently teach and may increase the inclusion of socio-economically deprived children living in challenging circumstances in mainstream education.
Abstract.
Hansford L, Sharkey S, Edwards V, Ukoumunne O, Byford S, Norwich B, Logan S, Ford T (2015). Understanding influences on teachers' uptake and use of behaviour management strategies within the STARS trial: process evaluation protocol for a randomised controlled trial.
BMC Public Health,
15Abstract:
Understanding influences on teachers' uptake and use of behaviour management strategies within the STARS trial: process evaluation protocol for a randomised controlled trial.
BACKGROUND: the 'Supporting Teachers and childRen in Schools' (STARS) study is a cluster randomised controlled trial evaluating the Incredible Years Teacher Classroom Management (TCM) programme as a public health intervention. TCM is a 6 day training course delivered to groups of 8-12 teachers. The STARS trial will investigate whether TCM can improve children's behaviour, attainment and wellbeing, reduce teachers' stress and improve their self-efficacy. This protocol describes the methodology of the process evaluation embedded within the main trial, which aims to examine the uptake and implementation of TCM strategies within the classroom plus the wider school environment and improve the understanding of outcomes. METHODS/DESIGN: the STARS trial will work with eighty teachers of children aged 4-9 years from eighty schools. Teachers will be randomised to attend the TCM course (intervention arm) or to "teach as normal" (control arm) and attend the course a year later. The process evaluation will use quantitative and qualitative approaches to assess fidelity to model, as well as explore headteachers' and teachers' experiences of TCM and investigate school factors that influence the translation of skills learnt to practice. Four of the eight groups of teachers (n = 40) will be invited to participate in focus groups within one month of completing the TCM course, and again a year later, while 45 of the 80 headteachers will be invited to take part in telephone interviews. Standardised checklists will be completed by group leaders and each training session will be videotaped to assess fidelity to model. Teachers will also complete standardised session evaluations. DISCUSSION: This study will provide important information about whether the Teacher Classroom Management course influences child and teacher mental health and well-being in both the short and long term. The process evaluation will provide valuable insights into factors that may facilitate or impede any impact. TRIAL REGISTRATION: the trial has been registered with ISCTRN (Controlled Trials Ltd) and assigned an ISRCTN number ISRCTN84130388. Date assigned: 15 May 2012.
Abstract.
Author URL.
Hansford L, Sharkey S, Edwards V, Ukoumunne O, Byford S, Norwich B, Logan S, Ford T (2015). Understanding influences on teachers' uptake and use of behaviour management strategies within the STARS trial: process evaluation protocol for a randomised controlled trial.
BMC Public Health,
15Abstract:
Understanding influences on teachers' uptake and use of behaviour management strategies within the STARS trial: process evaluation protocol for a randomised controlled trial.
The 'Supporting Teachers and childRen in Schools' (STARS) study is a cluster randomised controlled trial evaluating the Incredible Years Teacher Classroom Management (TCM) programme as a public health intervention. TCM is a 6 day training course delivered to groups of 8-12 teachers. The STARS trial will investigate whether TCM can improve children's behaviour, attainment and wellbeing, reduce teachers' stress and improve their self-efficacy. This protocol describes the methodology of the process evaluation embedded within the main trial, which aims to examine the uptake and implementation of TCM strategies within the classroom plus the wider school environment and improve the understanding of outcomes.
Abstract.
Author URL.
Marlow R, Norwich B, Ukoumunne OC, Hansford L, Sharkey S, Ford T (2014). A comparison of teacher assessment (APP) with standardised tests in primary literacy and numeracy (WIAT-II).
Assessment in Education: Principles, Policy and Practice,
21(4), 412-426.
Abstract:
A comparison of teacher assessment (APP) with standardised tests in primary literacy and numeracy (WIAT-II)
Assessing Pupils’ Progress (APP) arose from a government drive to increase the amount of teacher-based assessment within school and to make this consistent across schools. We conducted semi-structured interviews with head teachers to gain insight into how their schools applied APP and we compared the APP levels for English and Maths, provided by teachers across 11 schools for 72 pupils, to a standardised assessment (Wechsler Individual Achievement Test-II; WIAT). There was a strong correlation between the APP and WIAT for literacy but not for numeracy. Head teacher interviews revealed that APP is used differently across schools and at times is used in a way inconsistent with government guidance, which raises the question of how teacher assessments are used and their purpose. Questions that should be considered are; how is moderation used in schools, what is the function(s) of teacher assessments and what is good practice in relation to these assessments? Clarity about the function of assessments is of vital importance as is ensuring that assessments are meaningful to teachers, pupils, families and schools, especially in light of the weight that can be placed on teacher assessments for all these groups.
Abstract.
Norman S, Dean S, Hansford L, Ford T (2014). Clinical practitioner's attitudes towards the use of Routine Outcome Monitoring within Child and Adolescent Mental Health Services: a qualitative study of two Child and Adolescent Mental Health Services.
Clin Child Psychol Psychiatry,
19(4), 576-595.
Abstract:
Clinical practitioner's attitudes towards the use of Routine Outcome Monitoring within Child and Adolescent Mental Health Services: a qualitative study of two Child and Adolescent Mental Health Services.
Routine Outcome Monitoring (ROM) is held as a greatly important part of practice across many Health Care Services, both in the NHS and in private practice. Yet despite this, there has been little research into the attitudes of practitioners towards ROM. This paper looks at the attitudes of 50 clinicians from two Child and Adolescent Mental Health Services in greater London. The findings showed that although the practitioners were not overwhelming positive in their attitudes to ROM, neither were they overwhelming negative, and many of their concerns involved practical issues surrounding ROM that are potentially soluble. Practitioner engagement in ROM is key if ROM is to be used constructively to reflect on practice.
Abstract.
Author URL.
Chapters
Thomas F, Hansford L (2019). Supporting mental health in low-income communities: Implications for justice and equity. In (Ed) Practical Justice: Principles, Practice and Social Change, 54-68.
Conferences
Hansford L (2021). The Impact of Poverty on end of Life and Bereavement Experiences: Lived Experience of Bereaved Individuals and Professionals Working in Low-Income Communities in the United Kingdom. Public Health Research in Palliative Care: Towards Solutions for Global Challenges. 17th - 18th Nov 2020.
Abstract:
The Impact of Poverty on end of Life and Bereavement Experiences: Lived Experience of Bereaved Individuals and Professionals Working in Low-Income Communities in the United Kingdom
Abstract.
Publications by year
In Press
Owens, Hansford L, Sharkey S, Ford T (In Press). Needs and fears of young people presenting at Accident & Emergency department following an act of self-harm: Secondary analysis of qualitative data.
British Journal of PsychiatryAbstract:
Needs and fears of young people presenting at Accident & Emergency department following an act of self-harm: Secondary analysis of qualitative data.
Background:
Presentation at an Accident and Emergency (A&E) department is a key opportunity to engage with a young person who self-harms. The needs of this vulnerable group and their fears about presenting to healthcare services, including A&E, are poorly understood.
Aims:
To examine young people’s perceptions of A&E treatment following self-harm and their views on what constitutes a positive clinical encounter.
Method:
Secondary analysis of qualitative data from an experimental online discussion forum. Threads selected for secondary analysis represent the views of 31 young people aged 16-25 with experience of self-harm.
Results:
Participants reported avoiding A&E whenever possible, based on their own and others’ previous poor experiences. When forced to seek emergency care, they did so with feelings of shame and unworthiness. These feelings were reinforced when they received what they perceived as punitive treatment from A&E staff, perpetuating a cycle of shame, avoidance and further self-harm. Positive encounters were those in which they received ‘treatment as usual’, i.e. non-discriminatory care, delivered with kindness, which had the potential to challenge negative self-evaluation and break the cycle.
Conclusions:
The clinical needs of young people who self-harm continue to demand urgent attention. Further hypothesis testing and trials of different models of care delivery for this vulnerable group are warranted.
Abstract.
Allen K, Hansford L, Hayes R, Longdon B, Price A, Byford S, Norwich B, Ford T (In Press). Teachers’ views on the acceptability and implementation of the Incredible Years ® Teacher Classroom Management programme in English (UK) primary schools from the STARS trial.
British Journal of Educational PsychologyAbstract:
Teachers’ views on the acceptability and implementation of the Incredible Years ® Teacher Classroom Management programme in English (UK) primary schools from the STARS trial
Background
The Incredible Years® (IY) Teacher Classroom Management (TCM) programme may reduce disruptive behaviour in the classroom and improve child and teacher mental health, however few studies have considered how acceptable TCM is to teachers or what facilitators and barriers there are to its implementation.
Aims
In this paper we examine the acceptability of the full six-day TCM programme and teachers’ perceived barriers and facilitators to implementation in the English (UK) primary school context.
Sample
Forty-four English (UK) primary school teachers who attended the TCM programme as part of the STARS trial.
Methods
We completed focus groups and telephone interviews with participating teachers two months after they completed the TCM programme. Thematic analysis was used to examine the data, and a framework approach was applied to organise and summarise themes.
Results
Teachers liked the structure of the course, the peer group learning environment, delivery methods, and the opportunity to reflect outside the classroom on their practice. They reported that the video clips used lacked cultural relevance and highlighted the importance of group leadership style. Perceived facilitators to implementation included an understanding of the theory underpinning TCM and adaptability of the TCM strategies. Barriers included perceived gaps in the course content in relation to challenging behaviour, applying strategies with older children and the school context within which teachers were working.
Conclusion
Our findings suggest high levels of acceptability to TCM overall, but also highlight the need for a whole school approach to combat potential barriers to implementation.
Abstract.
Thomas F, Wyatt K, Hansford L (In Press). The violence of narrative: embodying responsibility for poverty-related distress. Sociology of Health and Illness: a journal of medical sociology
2022
Hansford L, Thomas F, Wyatt K (2022). How does housing affect end-of-life care and bereavement in low-income communities? a qualitative study of the experiences of bereaved individuals and service providers in the United Kingdom.
Palliative Care and Social Practice,
16Abstract:
How does housing affect end-of-life care and bereavement in low-income communities? a qualitative study of the experiences of bereaved individuals and service providers in the United Kingdom
Background: Access to affordable, appropriate housing is one of the key social determinants of health, affecting well-being across the lifecourse. However, beyond a recognition that housing quality is linked to place of death, little is known about the ways in which housing status impacts social, emotional, and practical aspects of dying and bereavement. Method: the Checking Out project is a qualitative study aiming to explore the ways in which socio-economic status impacts people’s experiences of, and attitudes towards, death, dying, and bereavement in the United Kingdom. Qualitative interviews were carried out with 14 bereaved individuals with experience of poverty at end of life or in bereavement, and 15 professionals supporting individuals in low-income communities. Interviews were conducted via phone/video call, and data include experiences of end of life and bereavement both before and during the pandemic. Transcripts were examined using thematic analysis. Results: Housing emerged as an important factor affecting people’s experiences, with 7 of the 14 bereaved individuals and all except 1 of the professionals discussing housing-related issues. Participants described ways in which unsuitable housing and housing insecurity impacted practical aspects of dying but also emotional and social well-being at end of life. Housing-related issues affected both patients and their families, though families found it difficult to air these concerns when their relative was dying. Conclusion: the paper demonstrates how trusted professionals are able to advocate or address the issues faced by bereaved individuals and suggests implications for policy and practice. A greater awareness of the potential impact of housing status across public services, including healthcare practitioners, welfare support, and housing providers, could better support patients and practitioners to address these issues proactively. Housing providers and policy-makers should be included as key partners in collaborative public health approaches to palliative care.
Abstract.
Hansford L, Thomas F, Wyatt K (2022). Poverty, choice and dying in the UK: a call to examine whether public health approaches to palliative care address the needs of low-income communities. Mortality, 1-17.
2021
Hansford L (2021). The Impact of Poverty on end of Life and Bereavement Experiences: Lived Experience of Bereaved Individuals and Professionals Working in Low-Income Communities in the United Kingdom. Public Health Research in Palliative Care: Towards Solutions for Global Challenges. 17th - 18th Nov 2020.
Abstract:
The Impact of Poverty on end of Life and Bereavement Experiences: Lived Experience of Bereaved Individuals and Professionals Working in Low-Income Communities in the United Kingdom
Abstract.
2020
Thomas F, Hansford L, Wyatt K, Byng R, Coombes K, Finch J, Finnerty K, Ford J, Guppy K, Guppy R, et al (2020). An engaged approach to exploring issues around poverty and mental health: a reflective evaluation of the research process from researchers and community partners involved in the DeStress study. Health Expectations, 24(S1), 113-121.
2019
Thomas F, Hansford L, Ford J, Wyatt K, McCabe R, Byng R (2019). How accessible and acceptable are current GP referral mechanisms for IAPT for low-income patients? Lay and primary care perspectives. Journal of Mental Health, 29(6), 706-711.
(2019). Practical Justice: Principles, Practice and Social Change.
Thomas F, Hansford L (2019). Supporting mental health in low-income communities: Implications for justice and equity. In (Ed) Practical Justice: Principles, Practice and Social Change, 54-68.
Allen KL, Hansford L, Hayes R, Allwood M, Byford S, Longdon B, Price A, Ford T (2019). Teachers’ perceptions of the impact of the Incredible Years® Teacher Classroom Management programme on their practice and on the social and emotional development of their pupils.
British Journal of Educational PsychologyAbstract:
Teachers’ perceptions of the impact of the Incredible Years® Teacher Classroom Management programme on their practice and on the social and emotional development of their pupils
Background
The Incredible Years® (IY) Teacher Classroom Management (TCM) programme may be an effective way to reduce teacher stress levels, improve child behaviour and promote positive socio-emotional development. However, few studies have considered what teachers think of the course and how it might work.
Aims
In this paper we examine teachers’ perceptions of the impact of the TCM programme and how it might work in the classroom.
Sample(s)
Fourty-four UK primary school teachers who attended the TCM programme as part of the STARS trial (Ford et al. 2018).
Methods
Focus groups and interviews were held with teachers two months after completing the TCM programme. Thematic analysis (Braun & Clarke, 2006) was employed to explore the subsequent data.
Results
Three main themes were identified: impact on the teacher; on children; and on parent-teacher relationships. Impact on the teacher included a positive change in their ethos. Teachers reported being more able to see things from the child’s perspective, placing a greater focus on building positive relationships, thinking before responding, feeling calmer, more confident and in control and employing strategies to create positive interactions with children. Teachers felt this had had a positive impact on their pupils’ development and relationships with parents. Feedback on whether or not TCM was effective in tackling particularly challenging behaviour was more mixed.
Conclusions
Our findings suggest that teachers experience the TCM programme as beneficial. This is discussed alongside other qualitative and quantitative studies in this field.
Abstract.
Hayes RA, Titheradge D, Allen K, Allwood M, Byford S, Edwards V, Hansford L, Longdon B, Norman S, Norwich B, et al (2019). The Incredible Years® Teacher Classroom Management programme and its impact on teachers’ professional self-efficacy, work related stress and general well-being: results from the STARS randomised controlled trial.
Journal of Educational PsychologyAbstract:
The Incredible Years® Teacher Classroom Management programme and its impact on teachers’ professional self-efficacy, work related stress and general well-being: results from the STARS randomised controlled trial
Background
Teaching is a stressful occupation with poor retention. The Incredible Years® Teacher Classroom Management (TCM) programme is a training program that past research has demonstrated may be an effective intervention for children’s mental health, but little research has explored any impacts there may be on the teachers’ own professional confidence and mental health.
Aims
In this paper we evaluate whether TCM may lead to changes in teachers’ wellbeing, namely a reduction in burnout and an improvement in self-efficacy and mental health.
Sample
Eighty schools across the South West of England were recruited between September 2012 and September 2014. Headteachers were asked to nominate one class teacher to take part.
Methods
Eighty teachers were randomised to either attend a TCM course (intervention) or not (control). TCM was delivered to groups of up to twelve teachers in six whole-day workshops that were evenly spread between October and April. At baseline and nine months follow-up we measured teachers’ mental health using the Everyday Feelings Questionnaire (EFQ), burnout using the Maslach Burnout Inventory-General Survey (MBI-GS) and self-efficacy using the Teachers’ Sense of Efficacy Scale-Short (TSES-Short).
Results
Using linear regression models there was little evidence of differences at follow-up between the intervention and control teachers on the outcomes (the smallest p-value was 0.09).
Conclusions
Our findings did not replicate previous research that TCM improved teachers’ sense of efficacy. However, there were limitations with this study including low sample size.
Abstract.
Hansford L, Thomas F, Wyatt K (2019). The impact of the Work Capability Assessment on mental health: claimants’ lived experiences and GP perspectives in low-income communities.
Journal of Poverty and Social Justice,
27(3), 351-368.
Abstract:
The impact of the Work Capability Assessment on mental health: claimants’ lived experiences and GP perspectives in low-income communities
This paper examines the impact of increased welfare conditionality on people with mental health issues claiming benefits in the UK. Drawing on data from the DeStress study, this paper explores the lived experience of welfare claimants in low-income communities, and the perspectives of GPs seeking to support them. Particular focus is placed on people’s experience of the Work Capability Assessment, the tool used to determine welfare claimants’ entitlement to sickness benefit, and how the narratives and culture surrounding welfare reform and the actual assessment itself can have a negative impact on mental health and wellbeing.
Abstract.
Ford T, Hayes RA, Edwards V, Logan GS, Norwich B, Allen KL, Hansford L, Longdon BM, Norman S, Price A, et al (2019). Training teachers in classroom management to improve mental health in primary school children: the STARS cluster RCT. Public Health Research, 7
2018
Thomas F, Hansford L, Ford J, Wyatt K, McCabe R, Byng R (2018). Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform.
Palgrave Communications,
4Abstract:
Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform
Associations between mental health and poverty are increasingly well established. Yet in neoliberally oriented contexts in which distress engendered through the everyday hardships of poverty is increasingly pathologised and medicalised, important questions are raised over the assumptions inherent within mental health policy and its implementation. Using the UK as a focus, this paper reviews and maps out key questions that require investigation in order to better understand the complex inter-relations between poverty and distress; explores how current paradigms might influence notions of individual responsibility and agency as well as health seeking behaviours; and examines the role of, and cultural and systemic expectations and constraints placed upon GPs as they respond to distress amongst patients from low-income communities. In so doing, we argue for recognition of the moral narratives that underpin both mental health care and processes of welfare reform, and call for an expansion of conventional notions of evidence-based healthcare to incorporate the understandings, experiences and priorities of people from low-income groups. We call for more detailed questioning and analysis of the interactions that lead to mental health diagnosis and treatment and better understanding of the relevance and effectiveness of current treatment options. As a central tenet of this, we argue for more flexible and nuanced healthcare responses that better reflect the dynamic and multi-faceted nature of poverty-related distress.
Abstract.
Thomas F, Hansford L, Ford J, Wyatt K, McCabe R, Byng R (2018). Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform. Palgrave Communications, 4
Titheradge D, Hayes R, Longdon B, Allen K, Price A, Hansford L, Nye E, Ukoumunne O, Byford S, Norwich B, et al (2018). Psychological distress amongst primary school teachers: a comparison with clinical and population samples. Public Health, 166, 53-56.
Ford T, Hayes RA, Byford S, Edwards V, Fletcher M, Logan G, Norwich B, Pritchard W, Allen K, Allwood M, et al (2018). The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial.
Psychological MedicineAbstract:
The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial
Abstract
Background. We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools’ important influence on child mental health.
Methods. A two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers
in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the
outcomes. Trial registration: ISRCTN84130388.
Results. Eighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (S.D.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference
= −1.0; 95% CI−1.9 to −0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori
subgroup analyses suggested TCM is more effective for children with poor mental health.
Conclusions. TCM provided a small, short-term improvement to children’s mental health particularly for children who are already struggling.
Abstract.
2015
Nye E, Gardner F, Hansford L, Edwards V, Hayes R, Ford T (2015). Classroom behaviour management strategies in response to problematic behaviours of primary school children with special educational needs: views of special educational needs coordinators.
Emotional and Behavioural Difficulties, 1-18.
Abstract:
Classroom behaviour management strategies in response to problematic behaviours of primary school children with special educational needs: views of special educational needs coordinators
© 2015 SEBDA Children identified with special educational needs (SEN) and behavioural difficulties present extra challenges to educators and require additional supports in school. This paper presents views from special educational needs coordinators (SENCos) on various strategies used by educators to support children identified with SEN and problematic behaviours. The data were collected from telephone interviews with six SENCos from the UK’s South West Peninsula. The SENCos were invited to participate because their school was participating in a cluster-randomised trial of a teacher classroom management course (Incredible Years). Using thematic analysis to analyse the data, this paper illustrates strategies deemed by SENCos to be successful in the support of children identified with SEN. The management strategies generated by participating SENCos were then mapped onto those taught as part of the classroom management course for comparison. Findings indicate that strategies from the training programme appear to be appropriate for children identified with both SEN and behavioural difficulties.
Abstract.
Hansford L (2015). Review of 'The SAGE handbook of child research'.
CHILD AND ADOLESCENT MENTAL HEALTH,
20(2), 126-126.
Author URL.
Marlow R, Hansford L, Edwards V, Ukoumunne O, Norman S, Ingarfield S, Sharkey S, Logan S, Ford T (2015). Teaching classroom management – a potential public health intervention?.
Health Education,
115(3-4), 230-248.
Abstract:
Teaching classroom management – a potential public health intervention?
Purpose – the purpose of this paper is to explore the feasibility of a classroom management course as a public health intervention. Improved socio-emotional skills may boost children’s developmental and academic trajectory, while the costs of behaviour problems are enormous for schools with considerable impact on others’ well-being. Design/methodology/approach – in total, 40 teachers attended the Incredible Years (IY) Teacher Classroom Management (TCM) intervention in groups of ten. Afterwards teachers attended focus groups and semi-structured interviews were completed with headteachers to explore whether TCM was feasible, relevant and useful, research processes were acceptable and if it influenced teachers’ practice and pupils. Teachers completed standardised questionnaires about their professional self-efficacy, burnout and well-being before and after attendance. Findings – in all, 37/40 teachers completed the course. Teachers valued sharing experiences, the support of colleagues in the group and time out to reflect on practice and rehearse new techniques. Most teachers reported that they applied the strategies with good effect in their classrooms. Teachers’ questionnaires suggested an improvement in their self-efficacy in relation to classroom management (p=0.03); other scales changed in the predicted direction but did not reach statistical significance. Research limitations/implications – Although preliminary and small, these feasibility study findings suggest that it was worthwhile proceeding to a definitive randomised controlled trial (RCT). Practical implications – Should the RCT demonstrate effectiveness, then the intervention is an obvious candidate for implementation as a whole school approach. Originality/value – Successful intervention with one teacher potentially benefits every child that they subsequently teach and may increase the inclusion of socio-economically deprived children living in challenging circumstances in mainstream education.
Abstract.
Hansford L, Sharkey S, Edwards V, Ukoumunne O, Byford S, Norwich B, Logan S, Ford T (2015). Understanding influences on teachers' uptake and use of behaviour management strategies within the STARS trial: process evaluation protocol for a randomised controlled trial.
BMC Public Health,
15Abstract:
Understanding influences on teachers' uptake and use of behaviour management strategies within the STARS trial: process evaluation protocol for a randomised controlled trial.
BACKGROUND: the 'Supporting Teachers and childRen in Schools' (STARS) study is a cluster randomised controlled trial evaluating the Incredible Years Teacher Classroom Management (TCM) programme as a public health intervention. TCM is a 6 day training course delivered to groups of 8-12 teachers. The STARS trial will investigate whether TCM can improve children's behaviour, attainment and wellbeing, reduce teachers' stress and improve their self-efficacy. This protocol describes the methodology of the process evaluation embedded within the main trial, which aims to examine the uptake and implementation of TCM strategies within the classroom plus the wider school environment and improve the understanding of outcomes. METHODS/DESIGN: the STARS trial will work with eighty teachers of children aged 4-9 years from eighty schools. Teachers will be randomised to attend the TCM course (intervention arm) or to "teach as normal" (control arm) and attend the course a year later. The process evaluation will use quantitative and qualitative approaches to assess fidelity to model, as well as explore headteachers' and teachers' experiences of TCM and investigate school factors that influence the translation of skills learnt to practice. Four of the eight groups of teachers (n = 40) will be invited to participate in focus groups within one month of completing the TCM course, and again a year later, while 45 of the 80 headteachers will be invited to take part in telephone interviews. Standardised checklists will be completed by group leaders and each training session will be videotaped to assess fidelity to model. Teachers will also complete standardised session evaluations. DISCUSSION: This study will provide important information about whether the Teacher Classroom Management course influences child and teacher mental health and well-being in both the short and long term. The process evaluation will provide valuable insights into factors that may facilitate or impede any impact. TRIAL REGISTRATION: the trial has been registered with ISCTRN (Controlled Trials Ltd) and assigned an ISRCTN number ISRCTN84130388. Date assigned: 15 May 2012.
Abstract.
Author URL.
Hansford L, Sharkey S, Edwards V, Ukoumunne O, Byford S, Norwich B, Logan S, Ford T (2015). Understanding influences on teachers' uptake and use of behaviour management strategies within the STARS trial: process evaluation protocol for a randomised controlled trial.
BMC Public Health,
15Abstract:
Understanding influences on teachers' uptake and use of behaviour management strategies within the STARS trial: process evaluation protocol for a randomised controlled trial.
The 'Supporting Teachers and childRen in Schools' (STARS) study is a cluster randomised controlled trial evaluating the Incredible Years Teacher Classroom Management (TCM) programme as a public health intervention. TCM is a 6 day training course delivered to groups of 8-12 teachers. The STARS trial will investigate whether TCM can improve children's behaviour, attainment and wellbeing, reduce teachers' stress and improve their self-efficacy. This protocol describes the methodology of the process evaluation embedded within the main trial, which aims to examine the uptake and implementation of TCM strategies within the classroom plus the wider school environment and improve the understanding of outcomes.
Abstract.
Author URL.
2014
Marlow R, Norwich B, Ukoumunne OC, Hansford L, Sharkey S, Ford T (2014). A comparison of teacher assessment (APP) with standardised tests in primary literacy and numeracy (WIAT-II).
Assessment in Education: Principles, Policy and Practice,
21(4), 412-426.
Abstract:
A comparison of teacher assessment (APP) with standardised tests in primary literacy and numeracy (WIAT-II)
Assessing Pupils’ Progress (APP) arose from a government drive to increase the amount of teacher-based assessment within school and to make this consistent across schools. We conducted semi-structured interviews with head teachers to gain insight into how their schools applied APP and we compared the APP levels for English and Maths, provided by teachers across 11 schools for 72 pupils, to a standardised assessment (Wechsler Individual Achievement Test-II; WIAT). There was a strong correlation between the APP and WIAT for literacy but not for numeracy. Head teacher interviews revealed that APP is used differently across schools and at times is used in a way inconsistent with government guidance, which raises the question of how teacher assessments are used and their purpose. Questions that should be considered are; how is moderation used in schools, what is the function(s) of teacher assessments and what is good practice in relation to these assessments? Clarity about the function of assessments is of vital importance as is ensuring that assessments are meaningful to teachers, pupils, families and schools, especially in light of the weight that can be placed on teacher assessments for all these groups.
Abstract.
Norman S, Dean S, Hansford L, Ford T (2014). Clinical practitioner's attitudes towards the use of Routine Outcome Monitoring within Child and Adolescent Mental Health Services: a qualitative study of two Child and Adolescent Mental Health Services.
Clin Child Psychol Psychiatry,
19(4), 576-595.
Abstract:
Clinical practitioner's attitudes towards the use of Routine Outcome Monitoring within Child and Adolescent Mental Health Services: a qualitative study of two Child and Adolescent Mental Health Services.
Routine Outcome Monitoring (ROM) is held as a greatly important part of practice across many Health Care Services, both in the NHS and in private practice. Yet despite this, there has been little research into the attitudes of practitioners towards ROM. This paper looks at the attitudes of 50 clinicians from two Child and Adolescent Mental Health Services in greater London. The findings showed that although the practitioners were not overwhelming positive in their attitudes to ROM, neither were they overwhelming negative, and many of their concerns involved practical issues surrounding ROM that are potentially soluble. Practitioner engagement in ROM is key if ROM is to be used constructively to reflect on practice.
Abstract.
Author URL.
