In most epidemiological studies, one in every five children and adolescents are said to display Emotional and Behavioural Difficulties (EDB), with greater risk of school and wider social exclusion (Brauner & Stephens 2006; Costello, Egger & Angold 2005). Although no formal statistics are currently available with regards EBD in Brunei, there was a formal report stating that quite a number of young people are now being referred to professionals for assistance and support for EBD. There is currently no assessment tool for EBD in Brunei and no ‘Brunei Malay’ translation for most of the Western design measures. Although some of these measures have Malay translations, it was formally back-to-back translated among professionals from Malaysia, who are known to speak slightly different standard Malay language than those Malays who reside in Brunei. Despite the differences in some technical language, Malays in Brunei and Malaysia share a very similar culture and geography. The aim of this study was twofold, to explore the responses of parents, teachers and adolescents in Brunei using the translation of the Western designed assessment tool for EBD as well as to determine how useful the original subscales of those measures are in reporting problems associated with EBD in Brunei Darussalam, a Malay speaking country based in the South East Asian region. A single phase cross sectional survey of 11-16 year-old adolescents attending mainstream public (i.e. government) schools in Brunei was carried out. Responses of parents and teachers were measured using the Strength and Difficulties Questionnaires (SDQ) and a subsample of the participants received a second copy of Child Behaviour Checklist (CBCL) and Teacher Report Form (TRF) of Achenbach measures. Responses from adolescents were measured using the Youth Self Report (YSR) of Achenbach measure. In total, responses were obtained from 396 parent version SDQ and 92 parent version of CBCL; 329 teacher version of SDQ and 71 teacher version of TRF; and 282 adolescent Youth Self Report (YSR) were obtained for analyses. Results indicated that there are some differences in the three different groups of respondents in Brunei in relation to the identification of EBD and that this differed somewhat from Western population studies. It is suggested that this may be due to differences in interpreting behavioural norms and that this might be linked to cultural differences. It was found that the YSR did not produce factor structure like that of the original study and this might indicate necessary refinement to ensure better fit as revealed by the psychometric analyses. Teachers’ responses to the SDQ items were more similar to those of teachers in other evaluation of the SDQ, whilst parents differed more in their responses when compared to those of Western respondents. Despite the clear differences in their responses when describing EBD using these Western measures, exploration of other statistical tests offered some possible reasons for continuing using the measures to report the prevalence of the problems. Previous studies have also highlighted some critical insights into the use of the measures in other cultures, which are discussed in the finding of this study. Some age and gender differences also appeared in responses, and there were a tendency for parents and adolescents in Brunei to report higher Total Difficulties Score (TDS) among girls than boys. The cut-off scores that were adjusted based on the criteria advocated by the founder of these measures indicated slight differences in the level of point describing the clinical range. This again served to highlight the possible cultural behavioural expectation that varies from one country to another. This exploratory study suggests that reporting a prevalence rate of a given culture using a measure that was designed elsewhere might pose risk of wrongly describing problems of a particular nature without investigating the way in which it has been understood by the respondent. The study stresses that it is important to understand cultural determinants of respondents when reporting EBD of adolescents and points out the necessity of planning and networking across social context to meet young people mental health needs.

The participation of children and young people (CYP) in decisions affecting them is high on the political agenda. CYP with special educational needs (SEN) in the form of social, emotional and behavioural difficulties (SEBD) continue to be under-represented in the literature with regard to participation and sharing their views. CYP with a statement of SEN must be formally reviewed on an annual basis, which is referred to as the annual statement review (ASR). The current research investigates how CYP with SEBD are presently participating in this formal and regular process that involves reviewing, decision-making and planning around their individual needs. A multiple case study was carried out, which involved two educational provisions, a resource based provision and a special provision, both for CYP with SEBD. Participants included the special educational needs coordinator (SENCo) in each provision, two CYP from the resource based provision, and one CYP from the special provision. Each of the three CYP were the focus of each individual case, with the two CYP from resource based provision being in Key Stage 2 and the individual CYP in special provision in Key Stage 4 of the National Curriculum. Main methods of data collection were semi-structured interview and observation throughout the ASR process. Data was analysed using thematic and content analysis. From a critical realist perspective, the investigation revealed that current practice to enable CYP with SEBD to participate in their ASR was found to be good, although it was proposed it could be better. This overall finding is based on the perspective that CYP should have the opportunity to make an impact on the ASR process as well as the outcome through decision-making, no matter how small the decision is that they are involved with. This was not always the case in the current practice examined in the study, more so with the younger CYP attending the resource based provision. The findings contribute to developing a good practice model for schools to support CYP with SEBD to effectively participate in review, decision-making and planning around their needs in statutory processes. A further research opportunity would be to investigate such practice in specialist provision for CYP with SEBD on a wider scale by using the survey design, to consider the current findings in a wider context.

Area of focus/rationale for the study: This study is an evaluation of an intervention, named Thrive, which is designed to promote the emotional development of children with Emotional and Behavioural Difficulties (EBD). The focus is to investigate the extent to which Thrive is effective in improving certain emotional and behavioural outcomes for children as well as exploring the experiences of those who are involved with the programme. The study is set out in two papers. Paper one assesses changes in pupil emotional well being over time using two subscales designed to measure specific aspects of resiliency, namely, ‘emotional reactivity’ and ‘sense of relatedness’. It also uses an assessment to measure changes in emotional and social skills which are considered important in order for pupils to engage in learning in a mainstream classroom environment (readiness to learn). Paper one also looks at the possible association between the Thrive training and staff attitudes towards pupils with EBD. Paper two explores, in depth, the experiences of the Thrive approach from the perspective of a small sample of school staff, pupils and parents. This process of exploration serves to better understand the outcomes from paper one by identifying a number of factors which may contribute to the successful or unsuccessful implementation of Thrive in a particular educational context. Context, Background and Research Objectives: Broad labels of ‘Emotional and Behavioural Difficulties’ (EBD) and’ Behavioural Emotional and Social Difficulties’ (BESD) tend to encompass behaviour which interferes with a child’s own or other’s learning; signs of emotional turbulence; and difficulties in forming and maintaining relationships. SEBD is used interchangeably with BESD (Behavioural, Emotional and Social Difficulties) in policy documents and theoretical writing (Evans, 2010). Schools tend to use the term EBD and this will generally refer to children whose behaviour and emotions prevent them and others from learning to their potential (DCSF, 2008). For ease and consistency I will use the term EBD throughout this study. The Special Needs and Disability Act (2001) sets out the right for children with EBD to be educated in mainstream schools. Due to the disruptive impact on learning for self and others, this group of children have been cited as one of the most difficult groups to include (Evans & Lunt, 2002). Behaviour management continues to be high on the education policy and practice agenda in England and the rest of the UK. Schools are faced with the challenge of finding ways of ensuring children with EBD are included in the ordinary classroom with their peers and to ensure that the needs of this vulnerable group of children are adequately met. Alongside this, Government Policy (e.g. NICE Guidelines, 2007) now requires schools to promote the emotional well-being of children who exhibit signs of emotional and behavioural disturbance. There is a demand for evidence based approaches to support children with EBD in mainstream schools from which professionals, such as Educational Psychologists, can draw on in order to make positive changes (see literature review in Appendix B.9 for more details). Thrive is a trademarked programme developed by a multidisciplinary team named ‘Fronting the Challenge’ (ftc). The programme is described as a ‘dynamic developmental approach to working with vulnerable and challenging children whose behaviour interrupts their own and others learning’. The Thrive programme borrows from a range of research and theory around neuroscience, child development, attachment theory and the role of creativity and play (for example Sunderland, 2006; Hughs, 2004; Illsey- Clarke & Dawson, 1989; Stern, 2003). It can be described as a school based intervention which is informed by a psychotherapeutic model as it aims to support children by addressing core relational and developmental features (Evans et al., 2003). Similar to nurture groups, Thrive is based on the understanding that for a child to develop a healthy ability to adapt to his or her social environment they must have experienced a sensitive, responsive and caring relationship with a significant carer/parent (Stern, 2003; Sunderland, 2006). But additional to a nurture group approach, the intervention draws on a concept from Transactional Analysis (Berne, 1964; Levin, 1982; Illsley Clarke & Dawson, 1998) which assumes that a child moves through a number of clearly defined stages of emotional development. The Thrive approach uses a computer based assessment, which relies on pupil observations, to identify specific ‘interruptions’ in this development; and targeted relational experiences, i.e., experiences of being in relationship with another human being, are recommended to promote further development. This will be discussed in more detail within the introduction of this thesis. As part of a wave two pathfinder for the Targeted Mental Health in Schools (TaMHS) Project under DCSF, in 2009, Thrive training was delivered to staff working with children and young people in three learning communities within a local authority in the South West of England. This included staff from approximately forty schools (including primary schools, secondary schools, a PRU and a special school) as well as multi-disciplinary staff such as CAMHS, Educational Psychologists and Behaviour support staff. At the time of beginning this study, thirty eight primary schools within the local authority had already been trained in Thrive and were implementing the intervention with some of their pupils. There was much testimony from staff working with children and young people that the training was highly valued and influential on their professional practice. Furthermore, there were a number of claims suggesting that pupils involved in Thrive were experiencing a whole range of positive outcomes attributable to the programme. For example, that the most disruptive pupils were calmer and making fewer visits to the Head Teacher’s office; that emotionally vulnerable children had become more confident and more trusting; that attendance had improved; and that the number of fixed term exclusions had diminished. Although there were a small number of detailed case studies prepared by schools themselves, the claims were, in the main, based on anecdote. Where schools had made some attempt to measure the impact of Thrive the methodology lacked basic rigour and findings were susceptible to bias; pre and post measurements were very limited and control measures were absent in all cases. The project lead for TaMHS reported ‘emerging’ data in relation to reduced numbers of fixed term exclusions, reductions in referrals to other services and referrals for statutory assessment. However, the source of this data was also said to be unreliable. Despite all of this, a general positive ‘vibe’ about the intervention based on a melange of potentially unreliable evidence was persuasive enough for the local authority to consider further investment into the intervention. Further details of current evidence related to the impact of Thrive can be found in Appendix A.1. Objectives of this study: • To provide a more reliable understanding of the effectiveness of the Thrive programme in supporting children with EBD within mainstream primary schools. More specifically: - To find the extent to which Thrive reduces pupil ‘emotional reactivity’, improves pupil ‘sense of relatedness’ and improves ‘readiness to learn in a mainstream classroom’. - To find whether there is an association between the Thrive training and staff attitudes towards the inclusion of children with EBD in mainstream primary schools. • To explore how a small sample of pupils, parents and staff experience Thrive.

School attendance problems experienced by children are a concern across Canadian educational systems. Higher rates of attendance issues exist among children who experience emotional and behavioural difficulties, which places them at heightened risk for poor educational outcomes. Frequently explored in educational research are variables related to school attendance problems among the general child population, however, a shortage of literature exists that explores these elements among children with emotional and behavioral difficulties. To address this void, this mixed-methods study explored child and educational elements that surrounded the school attendance problems of a sample of children receiving mental health services at a community clinic. Together, analyses of data gathered from the CANS, SDQ, and client files indicated that dynamic and reciprocal relationships existed among children’s emotional, behavioural, social, and academic difficulties which contributed to their attendance and overall educational experiences. These results corroborate existing research related to school attendance problems, however, provide unique insights into the profiles of this particular population and how their needs can be better met to promote more positive school experiences.

The study aimed to examine the extent of indigenous play or teret-teret, as a psychotherapeutic technique to assist young adolescents in their adjustment from socio-emotional and behavioural difficulties. Following a mixed-methods, the study was conducted in three phases. The qual then QUANT in the main study followed by QUANT - QUANT and finally qual was employed. Two hundred ninety-nine participants, with 13 in Phase 1; 221 in Phase 2, and 65 in Phase 3, were involved in the study. Thirteen participants were purposively selected based on their experiences and merits for Phase 1, while 221 were selected through multilevel probability sampling techniques for Phase 2. Among the 65 participants for Phase 3, five were selected randomly whereas 60 were selected purposely. Three data-gathering instruments, comprising in-depth interviews, archive analysis, and questionnaires were employed. This design explored the quality of 62 manifestations of indigenous teret-teret for use in psychotherapy. The qualitative phenomenological study confirmed teret-teret as a relevant psychotherapeutic technique, practised in Ethiopia for the adjustment of young adolescents who experience socio-emotional and behavioural difficulties. The intervention study revealed statistically significant differences between the participants who received teret-teret psychotherapy and those who did not receive teret-teret psychotherapy. It was found that teret-teret psychotherapy advanced the socio-emotional and behavioural competencies of the participants. The cross-sectional survey study verified a 43% prevalence rate of composite SEBD, with 50% being anxiety/depression, 45% somatic complaints, 44% attention problems, 43% delinquency, and 42% aggression, respectively. Implications were discussed about applying indigenous child-friendly stories, teret-teret, as psychotherapeutic techniques to help young adolescents who display socio-emotional and behavioural difficulties at schools and in community settings. / Inhloso yocwaningo kwabe kukuhlola izinga lomdlalo weshashalazi kumbe i-teret-teret, njengendlela yokusoconga ingqondo (psychotherapeutic technique)ukunceda abantu abasha abasesigabeni sobujongosi (adolescents) nokulawula isimo sabo ukusukela kwizinkinga zenhlalakahle yabantu ngokwemizwanangendlela yokuziphatha. Uma kulandelwa uhlelo lwezindlela ezivangene (mixed-methods design), ucwaningo lwenziwe ngokwehlukaniswa izigaba ezintathu: Isigaba soku-1: Uhlelo lwengxoxo (Qualitative)–idizayini yefenomenoloji (phenomenological design), Isigaba sesi-2: Uhlelo lwamanani (Quantitative) – idizayini yesaveyi (survey design) kanyeneSigaba sesi-3: Uhlelo lwamanani (Quantitative) – idizayini engenelelayo. Abadlalindima abangamakhulu amabili namashumi ayisishiyagalolunye, ngesigaba se 13 eSigabeni soku-1; 221 kuSigaba sesi-2 naku 65 eSigabeni sesi-3,zonke zazibandakanyekile ocwaningweni. Abadlalindima abayishumi nantathu babekhethwe ngenhloso ngenxa yolwazi lwabo kanye nomsebenzi wabo oncomekayo eSigabeni soku-1, kanti aba-221 babekhethwe ngokusebenzisa indlela yesampuli ebizwa nge-multilevel probability sampling techniques kwiSigaba sesi- 2.Hlangana nabadlalindima abangama 65 beSigaba sesi-3, abahlanu bakhethwe kuyo yinoma kuphi kanti aba60 bakhethwe ngenhloso. Amathuluzi amathathu okuqoqa idatha, aqukethe izinhlolovo ezijulile, ukuhlaziywa kwama-akhayivu, kanye nemibhalo equkethe imibuzo yizinto ezisetshenzisiwe. Le dizayini beyihlola izinga lemisebenzi engama 62 eveziwe yendabuko teret-teretngokusetshenziswa kuhlelo lokusocongwa kwengqondo. Ucwaningo olugxile kwifenomenoloji yengxoxo iqinisekise umdlalo we teret-teret njengendlela efanele yokusocongwa kwengqondo, okuyingqubo elandelwa ezweni lase-Ethiopia ngenhloso yokushintsha isimo sabantu abasha abasesigabeni sobujongosi abahlangabezana nobunzima kwinhlalakahle yabantu ngokwemizwa kanye nezinkinga ezimayelana nokuziphatha. Ucwaningo olungenelelayo luveze ngokwamanani imehluko egqamile phakathi kwabadlalindima abafumene ukusocongwa ngokomqondo ngomdlalo we teret-teret kanye nalabo abangakaze bathole ukusocongwa ngokomqondo ngeteret-teret. Kutholakele ukuthi ukusocongwa komqondo ngeteret-teret kuthuthukise inhlalakahle yabantu nangezimpawu ezikhombisa ukuziphatha kahle kwabadlalindima. Ucwaningo olubizwa nge-cross-sectional survey lufqinisekise 43% yezinga lokutholakala kwezinkinga zenhlalakahle yabantu ngokwemizwa nangokuziphatha (SEBD),okuyi-50% yezinga lentukuthelo/ingcindezi yengqondo, i-45% yezikhalo, i-44% yezinkinga ezidinga ukuxazululwa, i-43% yezinga lokuphambana nomthetho kanye ne-42% yokuba nolunya,kanjalo nje. Okuchazwayo lapha kuxoxiwe mayelana nokusebenzisa izindatshana zendabuko ezijabulisa izingane, teret-teret, zisebenza njengamasu okusoconga ingqondo ukunceda abantu abasha abasesigabeni sobujongosi abakhombisa izinkinga ezimayelana nenhlalakahle yabantu ngokwemizwa nangokuziphatha ezikoleni kanye nasezindaweni zemiphakathia. / Die doel van die studie was om ondersoek in te stel na die mate waarin inheemse spel of teret-teret, as ʼn psigoterapeutiese tegniek ingespan word om jong adolessente by te staan in hul aanpassing van sosio-emosionele en gedragsprobleme af. ʼn Gemengde-metodes-ontwerp is gebruik en die studie is in drie fases uitgevoer: Fase 1: Kwalitatief–fenomenologiese ontwerp, Fase 2: Kwantitatief – opname-ontwerp enFase 3: Kwantitatief – ʼn intervensie-ontwerp. Twee-honderd-nege-en-negentig deelnemers, met 13 in Fase 1; 221 in Fase 2 en 65 in Fase 3,is by die navorsing betrek. Dertien deelnemers is doelgerig gekies op grond van hul ervarings en meriete vir Fase 1, terwyl 221 deur meervlakkige waarskynlikheidsteek proefnemingstegniekegekies is vir Fase 2. Uit die 65 deelnemers vir Fase 3, is vyf ewekansig gekies, terwyl 60 doelbewus gekies is. Drie instrumente is ingespan vir data-insameling, naamlik diepte-onderhoude, argiefontleding, en vraelyste. Hierdie ontwerp het die gehalte van 62 manifestasies van inheemse teret-teret vir gebruik in psigoterapie ondersoek. Die kwalitatiewe fenomenologiese studie het bevestig dat teret-teretʼn relevante psigoterapeutiese tegniek is wat in Etiopië beoefen word vir die aanpassing van jong adolessente metsosio-emosionele en gedragsprobleme. Die intervensiestudie het statisties beduidende verskille getoon tussen die deelnemers wat teret-teret-psigoterapie ontvang het en dié wat nie teret-teret-psigoterapie ontvang het nie. Daar is bevind dat teret-teret-psigoterapie die sosio-emosionele en gedragsvaardighede van die deelnemers verbeter het. Die deursnee-opname het ʼn 43%-voorkomskoers van saamgestelde sosio-emosionele en gedragsprobleme (SEBD) getoon,met 50% daarvan angs/depressie, 45% somatieseklagtes, 44% aandagprobleme, 43% oortredings, en 42% aggressie,onderskeidelik. Implikasies is bespreek met betrekking tot die toepassing van inheemse, kinderviendelike stories, teret-teret, as psigoterapeutiese tegnieke om jong adolessente te help wat sosio-emosionele en gedrags probleme by skole en in gemeenskapsituasies toon. / Psychology of Education / Ph. D. (Psychology of Education)