Building the Programme Specification from Programme Theories

The next stage in building a Programme Specification involved the researcher studying the four Programme Theories about effective CMO configurations, in order to derive a main hypothesis from each of them. The evidence of Contexts, Mechanisms and Outcomes related to each of the four main hypotheses can then be predicted; in the Treasure Project programme these might be associated either with the effective promotion of children’s mental health and emotional wellbeing, or the effective building of capacity in schools to meet children’s emotional needs. The predictions were developed from the researcher’s knowledge and professional experience of the project (Shepherd et al., 2006, 2007).

Programme Theory 1, for example, states:

‘A project which is successful in promoting mental health and emotional wellbeing of children is long-term, school-based, multi-faceted, multi-level and works at changing the institution and environment, as well as individuals so that those elements such as organic factors, stress and exploitation are decreased and children’s coping skills, self-esteem and social supports are increased.’

The main hypothesis about effective CMO configurations arising from this theory was: ‘A project which is successful in promoting mental health and emotional wellbeing of children (O) is long-term, school-based (C), multi-faceted, multi-level (M) and works at changing the institution and environment (O) as well as individuals so that those elements such as organic factors, stress and exploitation are decreased and children’s coping skills, self-esteem and social supports are increased (O)’.

In this case, effective outcomes are viewed as: success in promoting the mental health and emotional wellbeing of children; success in changing an institution and environment so that elements such as organic factors, stress and exploitation are decreased; and thirdly, success in increasing children’s coping skills, self-esteem and social supports. Effective mechanisms would be multi-faceted and multi-level interventions, and effective contexts would be that the project is school-based and also the long-term nature of the project. The researcher then tried to predict the kind of evidence that might be found in the observations of the Treasure Project that would show if any of the CMO configurations contained in the main hypothesis might be operating in the programme. One such predicted outcome showing ‘success in promoting the mental health and emotional wellbeing of children’ might be that ‘school staff report an increased understanding of how children’s mental health and emotional wellbeing needs can be met in a school environment’.

The predicted hypotheses were then placed within an initial Programme Specification framework (Pawson and Tilley, 1997). This Programme Specification is shown as Table 3.5. The framework sets out the four main hypotheses associated with Programme Theories together with CMO configurations hypothesised for effective functioning of the Treasure Project programme. The researcher tried to include a broad range of CMO configurations in the resulting Programme Specification that might be predicted to be associated with effectiveness within the Treasure Project programme. She was aware that these predictions are only a limited representation of possible CMO configurations, since the Programme Specification is, of course, reliant on the quality of the literature the researcher has summarised and her knowledge of the activities of the Treasure Project. Timmins and Miller (2007) see the value of Realistic Evaluation as being that it encourages Programme

Specification, whatever the state of the knowledge base, and thus supports the testing of hypotheses. The outcome of the testing of these hypotheses through research leads to the reformulation of the initial Programme Specification from a position of increased

understanding of how a programme, like the Treasure Project, may actually work.

Therefore the CMO configurations shown in Table 3.5 are seen as a ‘good enough’ starting point for an enquiry (Timmins and Miller, 2007). It should be noted that the researcher has distinguished between Project and Non-Project Schools (see section 1.5i for definition). The table also uses the term ‘school staff’. This term includes all members of the school staff including Special Needs Coordinators, class teachers, teaching assistants, lunch time supervisors and any other adults working in the school. The term ‘trained school staff’ describes those members of the school staff who have participated in specific training courses designed to build their skills in a particular support approach, for example

Therapeutic Storywriting (Waters, 2004), or intervention such as Zippy’s Friends (Clarke and Brown, 2010; Mishara and Ystgaard, 2006). The various approaches and interventions are described in Appendix II.

Table 3.5: Initial Programme Specification of hypothesised CMO configurations about effective work in the area of mental health and emotional wellbeing promotion

General Hypothesis built from Programme

Theory 1

Hypothesised Evidence of Positive School

Contexts in the Treasure Project that might support General

Hypothesis built from Programme Theory 1

(with coding)

Hypothesised Evidence of Effective Mechanisms in the Treasure Project that might support General

Hypothesis built from Programme Theory 1

(with coding)

Hypothesised Evidence of Outcomes in the Treasure Project that might support General

Hypothesis built from Programme Theory 1

(with coding) A project which is

successful in promoting the mental health and emotional wellbeing of children (O) is long-term, school- based, multi-faceted, multi-level (M) and works at changing the institution and environment (O) as well as individuals (O) so that those elements such as organic factors, stress and exploitation are decreased and children’s coping skills, self-esteem and social supports are increased (O)

Project School with participatory relationship with Area Project Coordinator.

Interventions are valued and timetabled. PT1:C1) Non-Project School head teacher and all staff are interested in the promotion of mental health and emotional wellbeing. Interventions are valued and

timetabled. (PT1:C2)

Head teachers meet regularly with Area Project Coordinators to plan Treasure Project work around whole school needs in a multi- faceted and multi-level way. (PT1:M1) Whole school staff INSET training takes place around mental health and emotional wellbeing (PT1:M2) Area Project

Coordinators directly support children, young people and families (PT 1:M3)

Whole school projects are planned and implemented (PT1:M4) Some school staff are trained in specific approaches to support mental health and emotional wellbeing and interventions are put in place (PT1:M5)

School staff report increased understanding of how children’s mental health and emotional wellbeing needs can be met in a school environment (PT1:O1) Head teacher will be aware of positive whole school changes with regard to the promotion of mental health and emotional well-being of children (PT1:O2) Families will report positively about the Treasure Project and its impact on their

children’s wellbeing. (PT1:O3)

Trained school Key are enthusiastic about specific approaches and will use these

approaches to support vulnerable children after training (PT1:O4) Positive evidence of all and/or vulnerable children’s self-esteem and self-confidence increasing (PT1: 05) Positive evidence of all and/or vulnerable children coping skills increasing (PT1: 06) Positive evidence of all and/or vulnerable children’s social support increasing (PT: 07)

General Hypothesis built from Programme

Theory 2

Hypothesised Evidence of Positive School

Contexts in the Treasure Project that might support General

Hypothesis built from Programme Theory 2

(with coding)

Hypothesised Evidence of Effective Mechanisms in the Treasure Project that might support General

Hypothesis built from Programme Theory 2

(with coding)

Hypothesised Evidence of Outcomes in the Treasure Project that might support General

Hypothesis built from Programme Theory 2

(with coding) Effective

partnership work (O) in the area of promoting mental health and

emotional wellbeing of children (C) gives staff clear advice (M), guidance and support (M), increases their knowledge about childhood disturbance (O), is able to provide local, contextual knowledge (M), is able to offer good continuity of care and accessibility (M) and to act as a trusted link between home and school (M).

(built from

Programme Theory 2)

Project School with participatory relationship with Area Project

Coordinator. Interventions are valued and timetabled (PT2:C1)

Non-Project School head teacher and all school staff are interested in the promotion of mental health and emotional wellbeing. Interventions are valued and timetabled (PT2:C2)

Head teachers and/or school staff meet regularly with Area Project

Coordinator to plan work with school (PT2:M1) Whole school staff INSET training takes place around mental health and emotional wellbeing (PT2:M2) School staff approach Area Project Coordinator for advice, guidance and support (PT2:M2) Families are referred to Treasure Project

Educational Psychologist (PT2:M6)

Treasure Project team developed links with partner agencies in the area local to the school (PT2:M7) and Pathways for referral are understood and used when

appropriate (PT2:M8) Area Project Coordinator ensures parents have good knowledge of (and links with) Treasure Project work in school (PT2:M9)

Head teachers will comment positively on the advice, guidance and support of Area Project Coordinator (PT2:O1) Area Project

Coordinator’s advice, guidance and support is valued (PT2:O2)

Head teacher views school staff as more

knowledgeable about the promotion of mental health and emotional wellbeing.(PT2:O3) Families report positive outcomes from meeting with Educational Psychologist (PT2:O4) Partner agencies report strong links to Treasure Project (PT2:O5) Referrals Pathways to other agencies used appropriately (PT2:O6) Projects in school include local partners and agencies and school community (PT2: 07) Parents’ comments about Treasure Project work are positive (PT2:O8)

General Hypothesis built from Programme Theory 3 Hypothesised Evidence of Positive School Contexts in the Treasure Project that might support General

Hypothesis built from Programme Theory 3

(with coding)

Hypothesised Evidence of Effective Mechanisms in the Treasure Project that might support General

Hypothesis built from Programme Theory 3

(with coding)

Hypothesised Evidence of Outcomes in the Treasure Project that might support General

Hypothesis built from Programme Theory 3

(with coding) School staff and/or

volunteers supporting vulnerable children (C) are better able to positively impact on their socio-emotional health (O) if they have participated in

training (M), received supervision (M) and have followed through consistently with the approach they have been trained (M) in when working with children over a period of time (M).

Project School with participatory relationship with Area Project

Coordinator. Interventions are valued and timetabled. (PT3:C1)

Non-Project School head teacher and all school staff are interested in the promotion of mental health and emotional wellbeing. Interventions are valued and

timetabled. (PT3:C2)

Some school staff members are trained in interventions and/or therapeutic approaches (PT3: M10)

Area Project Coordinator facilitates the co-delivery of intervention with school staff (PT3: M11) School staff and Area Project Coordinators plan and reflect

before/after intervention delivery (PT3: M12)

Trained school staff set up interventions and use approaches (PT3: O1) Use of approaches or interventions continue after training (PT3: O2) School staff feel confident about delivering interventions or facilitating therapeutic groups without support (PT3: O3)

Further training is sought by school staff (PT3: O4)

Treasure Project and/or training courses recommended to head teachers in other schools (PT3: O5) General Hypothesis built from Programme Theory 4 Hypothesised Evidence of Positive School Contexts in the Treasure Project that might support General

Hypothesis built from Programme Theory 4

(with coding)

Hypothesised Evidence of Effective Mechanisms in the Treasure Project that might support General

Hypothesis built from Programme Theory 4

(with coding)

Hypothesised Evidence of Outcomes in the Treasure Project that might support General

Hypothesis built from Programme Theory 4

(with coding) Vulnerable

children’s mental health and emotional wellbeing is enhanced (O) through the participation in evidence-based interventions (M) delivered by trained adults (C).

Project School with participatory relationship with Area Project

Coordinator. Interventions are valued and timetabled. (PT4:C1)

Non-Project School head teacher and all school staff are interested in the promotion of mental health and emotional wellbeing. Interventions are valued and timetabled. (PT4:C2)

Groups are facilitated by trained staff (PT4: M13) Trained school staff or Area Project Coordinator facilitates/delivers interventions (PT4: M14) Vulnerable children are targeted for interventions (PT4: M15)

School staff report children’s mental health and emotional wellbeing enhanced (PT4: O1) Parents report children’s mental health and emotional wellbeing enhanced (PT4: O2) Children report that their mental health and emotional wellbeing enhanced (PT4: O3) Trained facilitators report children’s mental health /emotional wellbeing enhanced (PT4: O4)