The Hertfordshire Community NHS Trust children’s wellbeing practitioner team and children’s wellbeing practitioners (CWPs) are hosted by the public health school nursing service, however there is a new referral pathway to access support.
The CWP training programme was driven by Health Education England as a response to ensure that children, young people and their parents/carers have access to evidence based preventative and early intervention support for common emotional wellbeing and mental health difficulties. The aim of the HCT CWPs is to ensure that children and young people can easily access evidence-based support, early in the development of the problem through workshops, groups and 1-1 interventions.
CWPs are trained to deliver manualised guided self-help interventions for anxiety, low mood and behavioural difficulties.
There are four manualised guided self-help interventions available:
- Child anxiety (parent-led for children aged 5-11)
- Child behavioural problems (parent-led for children aged 5-8. Older children may be accepted in some instances)
- Adolescent anxiety (For young people aged 11-19)
- Adolescent low mood (For young people aged 11-19)
Please note, as highlighted above, child interventions for children aged 5-11 are completed with the parent(s)/carer(s) according to the manual and evidence base for those interventions.
CWPs are unable to work with children/young people who are currently actively self-harming or who are currently actively suicidal (having thoughts with intent and/or a plan). Please see the “making a referral” section below for more information on the criteria.
The CWPs also deliver several emotional wellbeing workshops throughout the year targeted at parents/carers and young people. These workshops are currently being delivered virtually via Microsoft Teams and a referral into the service is not required to access workshops.
The following workshops are either currently available or will be available later in the year:
- Child emotional wellbeing and regulation
- Emotional wellbeing for adolescents
- Child sleep difficulties
- Adolescent sleep difficulties
- Child self-esteem
- Adolescent self-esteem
- School transitions
- Exam stress
You can book a place onto a workshop via Eventbrite.
School avoidance/anxiety recorded webinar
It has been noted that a significant number of children and young people are struggling to attend school or avoiding attending school due to emotional factors like anxiety. The CWPs have recorded a webinar focused on school based anxiety which includes: anxiety psychoeducation and strategies and tips to support children who are currently struggling with attending school due to anxiety.
The webinar is split into Part 1 (Theory and Psychoeducation) and Part 2 (Strategies and Tips). There are handouts which can be used alongside this webinar. We would also advise you have some paper to hand whilst working through this webinar.
Take your time and watch the webinar as many times as needed. Feel free to pause when needed and at the times indicated.
Please make use of the following handouts:
- Body scan handout
- Parents step-by-step plan progress tracker
- Young people step-by step plan progress tracker
- Problem solving worksheet
- Step-by-step plan progress tracker
- Step-by-step plan template
- Step-by-step plan worksheet for parents
- Step by step plan worksheet for young people
- Strategies for managing difficult emotions
- Things I can do if I am struggling
- Thought challenging exercise
- Thoughts, feelings and behaviours cycle
- Vicious cycle handout
This service is available to children/young people aged 5-19 with a GP in Hertfordshire or who attends a school in Hertfordshire. This includes children attending private, independent and special provision schools as well as children and young people who are being home schooled or currently out of education. Referrals are accepted from professionals, parents and adolescents. Referrals need to meet the service criteria to be accepted.
In cases of emergencies or when urgent support is needed
We are not an emergency service and cannot hold high levels of risk therefore if you need urgent help, there are concerns around self-harm or suicidal ideation please contact Single Point of Access (SPA) on: 0800 6444 101 or NHS 111
If the child/young person is seriously unwell or injured, dial 999 for the emergency services or go to your nearest A&E department.
Operating hours: The service operates Monday to Friday, 9am and 5pm (excluding bank holidays).
- Contact the service
- How the service is provided
- Who is eligible for the service
- What will happen at your appointment
- Useful information
- Making a referral
Contact the service
Please email firstname.lastname@example.org
How the service is provided
The children’s wellbeing practitioner (CWP) team operates Monday to Friday 9am – 5pm (excluding bank holidays). However, some workshops are delivered outside of standard operating hours. The service covers the county of Hertfordshire and assessments and intervention sessions are currently offered in HCT clinic settings and schools in Hertfordshire as well as virtually using Microsoft Teams.
The team is made up of qualified and trainee CWPs who have either completed or are in the process of completing a children and young people (CYP) improving access to psychological therapies (IAPT) CWP post-graduate certificate. In addition, there is a CWP supervisor and the service development lead who also provides some clinical supervision.
CWPs are trained to deliver specific manualised guided self-help interventions for anxiety, low mood and behavioural difficulties.
Anxiety and behavioural interventions are available for children who are primary school aged, and these interventions are completed with the parent(s)/carer(s) according to the evidence base for those interventions.
Anxiety and low mood interventions are available for young people aged 11-19. These interventions are provided to the young person, but we encourage parent/carer input.
The HCT CWP team is hosted by the public health school nursing service but it is important to note that there is a separate referral pathway and criteria for the CWP team.
Who is eligible for the service
We will consider children and young people aged 5-19 who meet the service criteria and are registered with a GP in Hertfordshire or attend an education establishment in Hertfordshire. This includes children attending private, independent and special provision schools as well as children and young people who are being home schooled or are currently out of education. If a young person is out of education, they will need to be registered to a GP in Hertfordshire.
To be eligible for the service, the child or young person needs to be presenting with mild to moderate anxiety, low mood or behavioural difficulties where there is no to very low risk. Interventions differ depending on whether the child/young person is primary school or secondary school/college age.
Interventions for 5 –11 year-olds: Anxiety and behavioural difficulties
Interventions for 11 - 19 year olds: Anxiety and low mood
Please note interventions for primary school aged children are completed with the parent(s)/carer(s) according to the manual and evidence base for those interventions.
CWPs are unable to work with children/young people who are currently actively self-harming or who are currently actively suicidal (having thoughts with intent and/or a plan).
What will happen at your appointment
If your referral is appropriate for the support we can offer, you will be offered an initial assessment where a number of questions will be asked. The assessment will take place face to face in a clinic, community or education setting; alternatively, the assessment may take place virtually via Microsoft Teams.
Both parent/carer and child should be present for the assessment although for children under 8, many of the questions may be directed to the parent and for adolescents most of the questions will be directed at the young person. It is however important that we get the perspectives of the child/young person and their parent/carer. You can expect the assessment to take an hour but there may be some occasions where this overruns slightly.
At the beginning of the assessment the service offer will be explained, and confidentiality will be discussed. A confidentiality contract will usually be sent to you in advance of the assessment to be reviewed and then discussed at the assessment.
During the assessment you will be asked several questions. These questions help us to build a picture of what the problem is, any triggers for the problem, what is maintaining the problem, what is going well and what support may be most appropriate.
The questions you will be asked will focus on the following:
- The presenting problem and how it developed
- Any significant events
- Who is in the family and how things are going
- How the child/young person is doing in school
- Friendships and peer relationships in and out of school
- Strengths and what is going well
- Any current or historical risks
- Goals for support (What will hopefully be different by accessing support)
You will also be asked to complete a questionnaire as part of the assessment. All this information combined will help us to consider the best next steps.
Following your initial assessment, a decision may be made at the end of the assessment with you as to what support could be offered or the details of the assessment may need to be discussed with a supervisor first, before a decision can be made. If an intervention is to be offered, the details of the intervention/s will be explained at which point you can decide whether you want to proceed with one of the interventions suggested.
If an intervention is not being offered, we will explain why we do not think a manualised guided self-help intervention would be appropriate. We will also make recommendations about what support may be most appropriate.
All information shared during your assessment as well as any other communication is saved on our electronic health records system (SystmOne).
1-1 Intervention Sessions
If an intervention is offered this may either be provided 1-1 or in a group setting. 1-1 sessions are up to 60 minutes long and usually take place on a weekly basis. However, there are shorter check in/review sessions for the anxiety interventions.
To see a session-by-session overview for each intervention please click on the appropriate intervention below.
School Nursing Hertfordshire
Health for Kids and Health for Teens websites
Two local websites managed by the school nursing service, aims to provide children and young people with health and wellbeing advice and guidance.
Designed with creative materials and interactive tools, the websites also provide relevant signposting to other services in the county and contact details for the school nursing teams in each school.
- Health for Kids has been created for those aged four to 11
- Health for Teens has been created for those aged 11 to 19
Text messaging service
Chat Health is the school nurse text messaging service for all secondary school aged pupils. It is a confidential service and available Monday to Friday from 9am to 5pm. Young people can message for advice on all kinds of health issues such as sexual health, emotional health and wellbeing, bullying, healthy eating and any general health concerns.
The text number is: 07480 635050
Helpful Websites and Organisations
Emotional Wellbeing and Mental Health
- www.youngminds.org.uk – Emotional wellbeing and mental health advice and support for young people and parents. Parent helpline: 0808 802 5544 (Monday-Friday 9.30am-4pm). There is also an online webchat for parents.
- www.healthyyoungmindsinherts.org.uk - Children and Young People’s emotional well-being and mental health
- Step2 (CAMHS) - Mental health support for children and young people who have already accessed support but need further support. Step2 also complete ADHD pre-screens for children with a GP registered in South and West Hertfordshire
- www.kooth.com - Free, anonymous and confidential website where young people aged 10-24 can access free online services including; drop in chats with counsellors, booked 1:1 chats with a counsellor, themed message forums, secure web-based email and online magazine.
- Services for Young People (Previously YC Herts) - A number of projects are offered that support young people with their emotional wellbeing, young people with learning disabilities, support for young LGBT+ people, education and jobs
Parenting and Family Support
- www.hertsdirect.org/parentingsupport - Parent support and information within Hertfordshire
- www.familylives.org.uk - Parenting and family advice and support. Helpline: 0808 800 2222 (Monday – Friday 9am-9pm, Weekends 10am – 3pm)
- www.minded.org.uk - free online education to help parents/carers/professionals to identify and understand children and young people with mental health issues.
Sleep and Bedwetting
- https://sleepcouncil.org.uk/ Information and advice about sleep
- https://www.sleepfoundation.org/ Information and advice about sleep difficulties
- https://www.eric.org.uk/guide-to-bedwetting Strategies and advice for managing bedwetting
Autism, ADHD, Sensory and Functional Issues
- Autism information and support - For information, advice and signposting related to Autism.
- Spaceherts.org.uk - For information, advice and support for children and young people who have a diagnosis of Autism or ADHD or where these are suspected
- ADD-vance - Information, advice, support, training and workshops related to children and young people with a diagnosis of or suspected Autism and/or ADHD
- Children's Occupational Therapy - Useful information, strategies and support for children/young people who may be experiencing sensory, motor skills and other functional difficulties.
- Home - NESSie IN ED, CIC - Workshops focused on supporting children/young people with additional needs, particularly girls
- Calm Harm – Strategies for managing self-ham
- Calm – Mindfulness app to help improve emotional wellbeing
- Headspace – Mindfulness app used to help reduce stress, build resilience, and improve sleep.
- Think Ninja – Educates and provides skills and strategies for children/young people aged 10-18 years old who need mental health support.
- “Starving the Anxiety Gremlin: A Cognitive Behavioural Therapy Workbook on Anxiety Management for Young People” by Kate Collins-Donnelly (2013)
- “Helping Your Child with Fears and Worries 2nd Edition: A self-help guide for parents” by Cathy Creswell and Lucy Willetts (2019)
- “Breaking Free from OCD: A CBT Guide for Young People and Their Families” by Jo Derisley, Isobel Heyman, Sarah Robinson and Cynthia Turner (2008)
- “What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxiety” by Dawn Huebner and Bonnie Matthews (2005)
- “Anxiety Relief for Teens: Essential CBT Skills and Mindfulness Practices to Overcome Anxiety and Stress” by Regine Galanti (2020)
- “The Worry Workbook: The Worry Warriors' Activity Book” by Imogen Harrison (2020)
- “Mind Over Mood: Change How You Feel by Changing the Way You Think.” This is a cognitive behavioural workbook aimed at older teens and adults by Dennis Greenberger and Christine Padesky (2015)
- Ben Sedley (2015) “Stuff that sucks”. Published by Robinson. This is a useful book for young people who wish to develop their ability to cope with strong feelings and distress.
- “Anger Management Workbook for Kids: 50 Fun Activities to Help Children Stay Calm and Make Better Choices When They Feel Mad (Health and Wellness Workbooks for Kids)” by Samantha Snowden (2018)
Making a referral
To make a referral please complete the referral form below. Please ensure you read the guidance and complete the referral form in full.
Referrals are accepted from professionals, parents and adolescents for children and young people aged 5-19 who meet the service criteria. Children/young people need to be registered with a GP in Hertfordshire or attend an education establishment in Hertfordshire. This includes children attending private, independent and special provision schools as well as children and young people who are being home schooled or are currently out of education. If a young person is out of education, they will need to be registered to a GP in Hertfordshire.
You may also find it helpful to review the CWP criteria below.