Medway Short Intervention Therapy and Small Steps Positive Behaviour Support Evaluation

Task 

Following the ‘Complex Cases in Medway’ project conducted by TONIC in 2021, which reviewed the interface between Child and Adolescent Mental Health Services (CAMHS) and Social Care, Medway Council commissioned a new service called TOaST (Therapeutic Outreach and Support Team). TOaST was a pilot that attempted to combine therapeutic care and Positive Behaviour Support (PBS) into one service in order to prevent vulnerable children and young people escalating into crisis care.  

TONIC were asked by Medway Council to evaluate TOaST; however, due to implementation delays and issues with recruitment, TOaST was decommissioned and replaced by the Short Intervention Therapy and a separate PBS service. Thus, TONIC evaluated the two new respective pilots, focusing on what works with the services, areas for improvement and the extent to which they achieve intended outputs.   

Our Approach 

The evaluation utilised a mixed-methods formative process evaluation design, with an 8-month period of fieldwork to obtain quantitative and qualitative data. The principal method of data collection was through semi-structured in-depth interviews conducted with children and young people, their families or carers (primarily parents), and professionals; who either work for, alongside, or refer into the two services. Additionally, throughout the duration of the programmes, the providers have been collecting quantitative service activity and feedback data, which TONIC researchers analysed alongside the qualitative findings. 

In total, TONIC received 25 responses to the survey and conducted 32 in-depth semi-structured interviews. Of those respondents, 8 were children and young people, 26 were parents/carers and 23 were professionals.                          

Outcome 

TONIC produced a comprehensive written report that detailed the qualitative and quantitative findings of the evaluation; these were divided into strengths, areas for development and perceived impact. Areas for consideration, which took the form of mini recommendations for the service providers, were woven throughout the findings section. In addition, overarching recommendations were made to the council. 

Overall, the feedback received during the evaluation of both SIT and PBS was generally positive; parents, children and young people and professionals perceived the interventions to have a beneficial impact on those accessing the services. For example, children and young people who had engaged with SIT reported an improved level of wellbeing and described an increased ability to regulate their emotions, while parents who had received one-to-one support from PBS felt they were better able to meet the emotional needs of their child. However, the eligibility criteria for both services was perceived to be a challenge for both services who are currently not hitting their target numbers. Furthermore, TONIC recommended enhanced data capture processes in order to ascertain whether the services are meeting their intended outcomes.