Psycho-education, a cognitive approach and targeted practice proved to be effective elements in programmes aimed at improving young people’s social skills and resilience. The training setting and number of meetings are also important in this regard. Studies from the consortium Social skills have made this clear.
'Over the past three to four years, we have genuinely gained more insight into what works’, says Minne Fekkes, project leader of the consortium Social skills. The research in his consortium started with a meta-analysis of 60 manuals from international programmes aimed at improving children’s resilience. The researchers “chopped up” the programmes investigated into the most important techniques and for each technique they statistically analysed the effects of the exercises. Psycho-education, targeted training with practical exercises and working with cognitively-oriented exercises proved to be effective. However, a psychophysical approach, in which, for example, learning to trust others is practised during physical exercises, was found to be scarcely effective.
The knowledge from the meta-analysis was translated into small studies: microtrials. Each of these studies focuses on a single technique. In modules of four sessions the effectiveness of the technique was tested, for social skills themes such as self-confidence, speaking anxiety and prosocial behaviour. The trial about speaking anxiety made use of cognitive techniques. Renske van Hoeve from Centrum 16-22 helped to carry out the training sessions. She did not find that at all easy, she says, because the young people who she trained, from the Haagse Schilderswijk, were strongly do and goal-oriented and now they had to think things through a lot.
Van Hoeve felt that the cognitive approach is most suitable for pupils in pre-university education who are used to think things through a lot. However, that conclusion cannot be drawn so far, says Fekkes. Because the goal-oriented approach, with several practical exercises, which a colleague of Van Hoeve tried out, yielded ‘just as good’ or ‘perhaps slightly better’ results than the cognitive approach. This time, the question as to which young people benefit more from goal-oriented exercises and which benefit more from a cognitive approach was not part of the research. ‘We can hopefully investigate that question in the future.’
The training sessions that took place in a class and in a separate group, both have positive effects, but there were differences
For the socially less resilient pupils, the researchers determined the effect of a training session in the class situation compared to a separate training situation outside of the class. What did they find? Both forms have positive effects, but there were differences. In the class situation, the less resilient young people mainly became more skilful in dealing with classmates. The young people who trained in a separate group acquired more self-confidence and suffered least from depressive feelings. Both settings generated valuable effects, says Fekkes. ‘Which form you choose should depend on what exactly you want to achieve with the training sessions. As a trainer, you can discuss that in advance with the school.’
Another clear conclusion from the studies is that the number of sessions partly determines the effectiveness of the training course. ‘You can best give the training courses and the exercises in a certain number of sessions. That is another important insight. Many social skills training courses consist of rather a lot of sessions in which many themes are tackled, each accompanied by just a few exercises. We found that at least ten exercises per theme are needed, but for psycho-education slightly less suffice. That was revealed by the meta-analysis but also by our own microtrials.’
Choose the right techniques, apply them in the right amounts, clearly determine your goal(s) and match those with the type of training
‘Choose the right techniques and apply these in the right amounts. And in line with this, do not focus on too many different themes but clearly determine your goal(s) and match those with the type of training’, Fekkes sums up. All of these tips and other outcomes have now been translated into a tips booklet containing several pages with recommendations for setting up an effective training course. This tips booklet now substitutes the template the researchers originally intended to provide. ‘We felt such a template was far too restrictive’, explains Fekkes. ‘With so many different training courses, we want to be flexible.’
In the autumn, the tips booklet will be sent to all providers of interventions whose intervention was examined by the consortium. It will be sent with specific feedback, for example about whether the intervention contains too many or too few exercises, with a view to the effectiveness. Fekkes: ‘For example, we also want to communicate our conclusions concerning programmes that contain the most effective elements to municipalities and professionals since they select the interventions.’
Trainers often say that they tend to use their gut instinct, and then you often do not know whether something works or not
Fekkes is curious about the responses to the tips booklet. ‘People I talk with about our results are often enthusiastic. They say that they do a lot based on their gut feeling, and then you often do not know whether something works or not. With this evidence-based approach, they can work more effectively.’ Van Hoeve has already adapted her training courses to meet the recommendations from the tips booklet. ‘It is great to see that the recommendations agree with outcomes from the studies. However, there are also tips in this booklet that I can still learn from as well’, she says. ‘For example, I have the tendency to want to tackle too many themes. I’ll do that differently in future: better to have fewer themes with more effect. And I will definitely discuss the tips booklet with my colleagues.’
In the consortia Effectiveness of Psychosocial Interventions Youth, researchers and youth care organisations are exploring new possibilities for seven larger substantive themes related to growing up and parenting. The research provides knowledge about which (aspects of) interventions can best be used when, for who and by which persons. The key elements of interventions with proven effectiveness are the starting point for these interventions. Through innovative impact studies, the consortia provide answers to questions such as: What actually makes an intervention effective? Are there effective factors that can be found in all interventions? How can the care provider exert an influence on the impact? And: which interventions or aspects of these are cost-effective? Realising impact studies in an appropriate form is a challenge. Each consortium takes a different approach, but they work together to ensure that their approaches are well aligned with each other. The research from the consortia must improve the interventions and enable professionals and municipalities to choose an effective approach. The outcomes will make it possible to improve the effectiveness of professional practice and provide better help to children and families.
The consortia Effectiveness of Psychosocial Interventions Youth are working on these seven themes:
In the consortia, key elements of interventions will be investigated. But what exactly are those key elements? Key elements are the things that a care provider can do to teach desired behaviour to young people or their parents, guardians or carers. Or to diminish undesirable behaviour. This is given various names in the literature (e.g. components, elements, ingredients, kernels and techniques). We have chosen the term “key element” because this is used by most of the consortia and ties in well with the literature. As it is often not yet clear whether the element actually works, we ought to use the term “potentially effective key elements”. However, that is quite a mouthful. A collection of these key elements defines an intervention. Structural elements also play a role in defining an intervention. For example, the sequence, frequency and intensity of the key elements involved.
In the Netherlands, many interventions are available for young people in the area of social skills and resilience, but it is not clear which are the most effective. A research consortium from TNO, University of Amsterdam, Radboud University, Leiden University and organisations from professional practice investigated to what extent aspects from these programmes are effective. Of the four techniques investigated, three were found to increase the effectiveness of programmes: practising skills, a cognitive approach (aimed at changing unhelpful thoughts and emotions into helpful ones) and psychoeducation. The use of psychophysical exercises has no effect. When practising the skills (the target behaviour) it is important that the programme includes enough practice sessions (at least 10). Programmes with a duration of 10 to 16 weeks have the greatest effects. The setting also makes a difference: interventions in the classroom mainly influence interpersonal skills, and interventions in which children who need it are trained in a group mainly improve the intrapersonal outcomes. Both children and their parents as well as professional practitioners prefer to use active work forms in which the young people practise skills and receive practical tools to become more socially resilient.
This project makes it clear that some interventions in the Netherlands deploy many effective elements, whereas others do this to a lesser extent. With this insight, parents, schools and municipalities can choose more effective interventions by checking whether the effective elements are part of the intervention programme. The research results give professionals and organisations more insight into the effectiveness of the techniques and elements in the various social skills training courses. This can help them to deploy new interventions more effectively. All of the insights collected have been summarised in a set of tips. These provide support during the development of future social skills training courses, and help to improve and strengthen existing training courses. In addition, recommendations for the owners of the interventions have been compiled and the outcomes will be disseminated among professional practitioners, municipalities, schools and parents.
Text Veronique Huijbregts. Translation Dave Thomas. Portraits Sannaz Moghaddam. Photos header Studio Oostrum.