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Learning to manage worries - Sefton Council

The school nurse team in Sefton helped children spot the signs of worry, and how to build resilience.


The School Nurse team in Sefton were seeing a large number of children in year 6 reporting worries about their SATs and their move to high school. In response, the school nurse for emotional health and wellbeing developed a two-session intervention ‘Learning to manage worries’ that school nurses could deliver in primary schools. After two successful pilots, the programme was rolled out across all primary schools.

Spotting the signs of worry and building resilience

The sessions were intended to encourage resilience in children, develop future life skills and respond to growing demand for mental health needs. Cognitive Behavioural Therapy (CBT) techniques were used as this looks at thoughts, feelings and behaviours and makes connections between all of these.

The first session looked at what worry is, the physical symptoms of worry and how to recognise when the anxious thoughts were coming it. The session also started to look at mindful breathing, finger breathing and repeated positive affirmations.

The second session looked at how worry makes someone behave, for example, being rude to family or withdrawing from friendships. It is also looked at building resilience, identifying a circle of support and how that could be built on during the transition to secondary school. The training also normalises and de-stigmatises mental health worries. Looking at what helps such as; worry trees, writing a journal and talking about what already helps when you are feeling worried; talking to pets, exercise and playing football.

Improved learning and children managing their worries better

The sessions were evaluated afterwards with a questionnaire for all the year 6 children, and feedback from the class teachers and school nurses. The questionnaire results showed positive feedback and a headteacher reported improved SATs results, attributing this in part to the intervention. Young people said that they now know how to manage their worries, that they are not alone and that it is normal to worry. Some young people still re-called the training in year 8 and still used the techniques they learnt.

Earlier intervention saves time in the long term

Studies have shown that school nurses can lack the confidence or feel they do not have the correct skill set to deliver early intervention work to support children’s mental health. But being supported by a specialist emotional health and wellbeing nurse to co-facilitate sessions made a big difference. School nurses reported this as one of their favourite interventions to deliver, as well as helping them to identify children who were struggling more and saved them time in the long term. 

Impact of Covid-19

During Covid-19, transitions to secondary school became more of a concern as children had been out of school for a long time and some activities like visiting secondary schools wasn’t able to take place. The school nurse lead filmed the sessions and sent these out to schools and families so they could go through the sessions in their own time.

What next?

The move to virtual sessions has worked well, and this will be built on with films of year 7 assemblies and virtual training for school nurses.

In addition, the school nurse teams are also looking at how they can support children in secondary schools and noting there were several of the same children attending drops ins, a specific group as been developed which will focus on areas that are of most importance to them. This will include; bereavement, managing emotions, over-thinking and the teenage brain. These will take place when children go back to schools.

For more information contact: 

Catherine Brindle, Specialist Children’s Nurse, Emotional Health and Well-being, Sefton.