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While there currently appears to be no universal definition for Emotional Behavioural Difficulties (EBD) it is often used around the world as a label for children displaying difficult behaviours. One intervention used for children with EBD is residential treatment, which involves “providing a full range of therapeutic, education, recreational and support services given by a professional, interdisciplinary team” (Johansson 2007, pg. 16). To date there is little literature on the effectiveness of residential treatment for children with EBD. This present study aims to further the research by measuring the progress made towards a child’s personal goals while at residential school and if this progress is still evident six months after returning home and entering mainstream schooling. Child and parent feedback on the time spent at residential treatment are examined to see how they viewed the treatment. The participants consisted of 83 children aged seven to thirteen years who had attended the residential school between 2004 and 2009, their parents/caregivers, mainstream teachers and residential treatment staff. Follow up questionnaires given to the parents/caregivers when the child was leaving residential treatment and the child’s leavers report were analysed using a mixed methods approach. The results of this study indicated that the children’s personal goal attainment did not change at a statistically significant level six months after returning home and entering mainstream schooling Findings were consistent across the three age groups analysed (under 8 years 11 months, 9 years -10 years 11 months and over 11 years) as well as across the goal codes. This research suggests the gains the children made towards goal attainment at residential treatment were able to be generalised to their home and mainstream school environment.

Research has previously highlighted the physical, social, affective and cognitive benefits of engagement in quality physical education (PE) (Bailey, 2006). Furthermore, practical, physical and expressive creative experiences in education have also been cited as being an important constituent when educating children and young people with social, emotional and behavioural difficulties (SEBD) (Cole and Visser, 1998). However, research has yet to address the experiences of the child with SEBD, as told by themselves, alongside the ideological benefits of their participation in physical education. As such, this study has examined how children and young people experience the National Curriculum of PE in England and Wales. Specifically working with those deemed by their school to have SEBD, this study aims to give voice to how participants create meaning of their PE experiences. A case study methodology was adopted whereby, after a period of piloting and familiarisation, two periods of twelve weeks were spent with six adolescent boys, each described by their schools as having SEBD. A range of participatory methods were used to elicit their perceptions of PE. Inductive processes of analysis generated outcomes which showed signs of the idiosyncratic nature of varying experiences and multiple truths. A number of themes emerged from the analysis of each case, aside to the contextualised responses of individuals. Participants spoke of their affinity towards the inherent practical nature of PE, which appeared to be forgiving of their desire for cathartic opportunities to participate physically. They regularly discussed their perception of PE being a subject allowing for relative freedoms not found elsewhere in their curricula. Narratives which described their experiences were also characterised by issues which focussed upon the non-educational aspects of the subject. The perceived pardon from the academic demands of school life, and the subsequent opportunities for socialisation with peers, were described as times which cemented the both positive and negative social systems at place in their classes. ii The case studies have resulted in the discussion of experiences which demonstrate the rich and highly individualised nature of children and young peoples‟ time in PE. The nature of their difficulties appeared to exacerbate and heighten the responses to participation which have been commonly reported in previous studies. Participants‟ time in PE was shown to be an example of the challenges that they face in their school lives more broadly. PE served to magnify both the positive and negative responses to education that were described as being experienced elsewhere in their curriculum subjects. This research has shown that, when adopting methodologies which privilege participatory methods, it is possible to gain greater depth of understanding as to how children with social emotional and behavioural difficulties experience physical education.

The poor outcomes of young people leaving foster care are well documented and demand a focus on placement permanency and interventions that encourage stability (Rubin et al, 2007). The need for better support for foster carers is widely acknowledged (Warman, Pallet & Scott, 2006; Morgan & Baron, 2011). To provide effective support an understanding of foster carers support needs is required. A qualitative approach explored the support needs of foster carers who look after young people perceived to have emotional and behavioural difficulties. Semi- structured interviews were undertaken with 17 foster carers employed by a local authority or an Independent Fostering Agency. A grounded theory methodology within a social constructionist framework was used to develop a new theoretical understanding from the data. A central storyline of ‘keeping your head above water’ emerged and appeared to encapsulate daily struggles and ways of managing. Categories which contributed to this were ‘becoming isolated’ from other professionals, ‘role ambiguity’ regarding the multiple meanings attached to being a foster carer, ‘making sense of emotional and behavioural difficulties’ highlighting a need to understand the children cared for, ‘a focus on behaviours’ illuminating approaches to parenting and ‘unmet emotional needs’ which is a possible consequence of focussing on children’s behaviours. The emergent theory may hold potential for developing psychological formulations, interventions and training programmes for foster carers. Suggestions for future support are put forward based on the new theoretical framework. Applications of the findings to Counselling Psychology are discussed in detail.

Paper 1: An exploratory study of the systems of support to help young males with Social, Emotional and Behavioural Difficulties to remain in post 16 Education Abstract This paper is positioned within a co-operative inquiry interpretative paradigm. This paper is one of two. This study focused on YP with Social, Emotional and Behavioural Difficulties (SEBD) and their views and experiences of the system of support to help them remain in EET. An adapted co-operative inquiry (CI) methodology was employed which emphasised participation This research aimed to address this gap by giving voice to the YP and their views of the education system. Additionally, the views of the YP were sought to deepen our understanding of YP’s needs and level of support they require to remain in EET. The research took place in a unitary authority in the South West of England. The participants in paper one were five male students who had left specialist provision for YP with SEBD following completion of year 11. Ages ranged from 16.5-17 years. Their views were elicited through individual semi-structured interviews which were analysed using a thematic analysis approach (Braun and Clarke 2006). The key finding from paper one was the value YP placed on relationships they formed with practitioners who supported them. For many of the YP Grovehill School (SEBD) was their first positive experience of the education system. The YP making the transition into mainstream EET expressed the view that there was no support in place once they left Grovehill. Additionally, the lack of practitioners in post-16 that knew and understood their needs, coupled with feelings of a lack of belonging and acceptance in their new environment, were identified as particularly challenging. Three out of the five participants became NEET before the end of their second year of post-16 EET. The YP identified the presence of Erica, a learning mentor as the most important source of support. However when the YP were unable to access Erica it was evident that the lack of a wider system of pastoral support presented as a significant challenge for this vulnerable group. Findings from papers one and two were assimilated and the implications for improving future policy and practice were considered in the final section of paper two. Consideration was also given to the role Educational Psychologists (EPs) and how EPs could inform future ways of partnership working to secure positive outcomes for YP with SEBD. Paper Two: An exploration of practitioner’s view of the current system of support for YP with SEBD making the transition into post-16 mainstream education, employment and/or training Abstract The aim of this paper was to explore practitioner’s views and experiences of the system of support in place to meet the need of YP with SEBD making the transition from specialist to mainstream post-16 EET. This small scale study was conducted in a unitary authority in the South West of England. A total of eleven participants took part in the semi structured interviews (six males and five females). The participants were selected to represent the range of provisions offered to YP with SEBD in post-16 EET. Semi-structured interviews were used to elicit their views. A thematic analysis approach to analysis was adopted. Findings were that practitioners identified the importance of cultivating caring relationships, however, a distinction emerged in the FE setting were the focus was on behaving like an adult and conforming to an existing system. Disparities also emerged between settings value and beliefs systems, which appeared to shape the teaching practice and interaction with YP. The lack of support practitioners receive from outside agencies to understand and support YP with SEBD emerged as important factor. Additionally, issues such as the impact of the change of environment from specialist to mainstream EET and school culture emerged as salient features. The dilemma of inclusion versus attainment was found to be a significant challenge for practitioners when trying to meet the needs of the YP. Findings which related specifically to transition identified; across settings there was a lack of a formal transition plan and limited access to resources and funding in post-16 settings. Within FE settings the lack of accessible pastoral support was identified as a key area for development. Finally, all participants identified the need for a clear strategic vision to inform future practice. Systems theory provided a useful conceptual framework to understand the complexity of the interlinked factors which impact on YP access, or lack of access to support to help them remain in EET. Shared themes were identified across the phases of the study which identified that it is not one single factor, but rather a combination of interlinked factors which contribute to YP becoming NEET. The information gathered showed participants across the settings recognised the need for greater partnership working and help for practitioners to help them understand and support YP with SEBD. The study also illuminated the need for better communication between practitioners and the wider system of support. Additionally, the study identified a clear role for EPs in supporting YP and practitioners and implications for EP role are discussed. The study has provided a timely insight into the current system of support for YP with SEBD in light of the move for YP to remain in EET up until the age of 18.

Therapeutic and support services provision for children with dual intellectual disability and emotional and/or behavioural difficulties was evaluated in the present study. The participants were parents of children with dual disabilities, aged between 5 and 12 and attending mainstream schools in Christchurch, New Zealand, and managers of service providers for the target group. Parents and service managers partook in semi-structured interviews designed to obtain information about patterns of service provision. The results of the present study indicate that parents and managers had similar perceptions of the extent to which services in Christchurch currently met the needs of the target children and families. Additionally, the study functioned as a pilot of the design and methods for a potential future project; therefore parent participants also completed two checklists estimating their child’s adaptive functioning and the type and severity of their emotional and/or behavioural difficulties.

Theory and research supports the implementation of cognitive and behavioural interventions (CBI’s) to address social, emotional and behavioural difficulties (SEBD) in children. The literature argues that schools are an ideal place in which to implement such interventions. As part of a county initiative, school staff were trained and offered follow up support by 2 Educational Psychologists (EPs) around the use of school-based CBI to support children who have SEBD. The 10 participants (from 5 schools) in this research were part of this initiative: they received 4 sessions of training followed by either monthly individual supervision, or group supervision, around their use of CBI. Training and supervision targeted implementation of key CB competences, selected from a competency framework recommended by ‘Improving Access to Psychological Therapies’ (IAPT, 2011). The research explored staff perceptions around the CB competences that they implemented, their methods of implementation and the barriers and facilitators to their implementation. The research used a mixed methodology design. Qualitative data was analysed using thematic analysis and quantitative data was analysed using descriptive statistics. Data was gathered through interviews, supervision sessions, intervention diaries and training evaluations. Exploration of facilitators and barriers to implementation was based on Durlak and DuPre’s (2008) model of intervention implementation. Facilitators/barriers discrete from this model were also identified. Identification and exploration of such factors can assist in ensuring quality implementation of school-based interventions in the future. This study demonstrates how school staff can implement a range of CB competences and through multi-levels of intervention in schools. The potential role of the EP in supporting school staff to implement CBI is also discussed.

Focal epilepsy in childhood is associated with increased risk for developing behavioral, emotional, cognitive and social–adaptive impairments. The present thesis focused on mental health difficulties in paediatric refractory focal epilepsy. It undertook a detailed evaluation of the predictive power of several demographic (gender, age at assessment), clinical (age at onset and duration of epilepsy, seizure frequency), localization (lobe and lateralization of pathology) and cognitive variables (performance in intellectual, memory and academic attainment measures) for mood, conduct, inattention/hyperactivity and peer relationship difficulties, as assessed by parental report. Data from a population of 282 children and adolescents, previously collected for clinical purposes, were examined, using a series of univariate and multivariate analyses. Mental health difficulties were found to be highly prevalent, with peer relationships the most frequently reported area of difficulty, followed by inattention/hyperactivity and emotional difficulties. Different patterns of associations between the variables examined here and individual emotional/behavioural difficulties were revealed, partially confirming and extending previous findings in the literature. Longer duration of epilepsy was found to increase the risk for developing emotional difficulties; male gender and earlier age at onset the risk for conduct difficulties; male gender, earlier age at onset, longer duration and frontal lobe localization the risk for attention/hyperactivity difficulties; and finally longer duration, higher seizure frequency and right hemisphere lateralization the risk for peer difficulties. Lower cognitive functioning was found associated with overall increased mental health difficulties and a lower VIQ was predictive of all types of difficulties. Developing a firm understanding of the risk factors that contribute to mental health comorbidities in focal paediatric epilepsy can help identify and provide assessment and intervention to children who are at higher risk earlier, thus significantly improving quality of life.