Cues-Ed: Preventative Mental Health Training in School

Tackling the root cause of offending through therapeutic intervention.

What is the project?

Coping with Unusual Experiences Study - Education (CUES-Ed) Programme CUES-Ed is an innovative psycho-education project based in primary schools, which helps children recognise, and make links, between thoughts, feelings and behaviour. CUES-Ed teaches children how to notice the signs (“cues”) when things aren’t right, such as an increase in worry, a change in appetite or sleep patterns and difficulties with friendship groups. CUES-Ed also teaches young people basic cognitive coping strategies and behavioural techniques, to help them manage difficulties. CUES-Ed provides children with a range of interactive materials to reinforce the messages of this 8-session Programme.

 We liaised with CUES-Ed Psychology team at the South London and Maudsley NHS FoundationTrust (SLAM) on two new projects:

We successfully delivered the Teaching sessions to two Year 5 classes at the South Hampstead High School. It was received with great enthusiasm and the students found it very helpful.

CUES-Ed Psychology team at the South London

CFMH Mental Health Prevention Programme in Schools Initiative

Last year, Concern for Mental Health collaborated with the CUES-Ed Psychology team at the South London and Maudsley NHS Foundation Trust (SLAM)

We are delighted to report that we have initiated, and augmented, a collaboration between CFMH, CUES-Ed team and South Hampstead School. CUES-Ed programme is a whole- class programme designed to raise awareness of mental health challenges and to improve emotional well-being of primary school children.The programme teaches the importance of noticing the signs when things are not going right, and also provides youngsters with simple, yet practical tips they can do to manage everyday life ups and downs, both at school and home. The CUES-Ed team has delivered the programme to two Year 5 classes, to a total of 45 girls at the at South Hampstead Junior School.The girls attended the CUES-Ed programme enthusiastically, and have learned how to improve its general and emotional well-being and how to look better after “basic” everyday life habits, such as eating healthily, sleeping well and relaxing – all known to positively impact on emotional well-being, yet easily forgotten! According to the girls, the best part of the CUES-Ed programme were the coping strategies to solve the problems and how to respond to confusing situations without jumping to conclusion.

The success of CFMH Mental Health Prevention Programme in Schools Initiative, and constructive and productive, collaboration with the CUES-Ed team and South Hampstead School, will continue next year.

The CFMH team is currently in negotiations with a number of other schools for the delivery of the CUES-Ed programme, and is also working on developing a Mental Health Prevention Programme for 14 to 18-year-olds and a Teach-the-Teachers Education Programme, which we will pilot in the UK, and later in other languages /countries.

Dr Jasmina Nina Zugic
Educational Development Consultant
Concern for Mental Health

CUES-Ed is a whole class programme designed to promote mental health and improve emotional well-being.

The programme was funded by Concern for Mental Health to be delivered to two year 5 classes at South Hampstead Junior School in the AutumnTerm 2018.The children and teachers completed standardised measures before and after the programme to assess its impact, including the Me & My Feelings questionnaire (MMF; Deignton et al., 2013) and Children’s Outcome Rating Scale (CORS; Duncan, Miller & Sparks, 2003).

Improved general, emotional and behavioural wellbeing

  • Children initially scoring above the clinical threshold for emotional and behavioural difficulties on the MMF reported improvements following CUES-Ed, with behavioural difficulties significantly improving (p=0.02).
  • Year 5’s average general well-being score significantly improved on the CORS (p=0.002). Children in the low scoring group (score <32) also improved following the intervention.
  • Children in the lower scoring group also reported significantly improved ratings of how things are with their friendships, learning, and behaviour following CUES-Ed (p=0.005, p=0.001 and p=0.001 respectively).

Children are better able to look after themselves

  • Children reported being significantly better able to look after their ‘basic’ well-being, including eating healthily, sleeping well and relaxing (p<0.001, p=0.042 and p=0.001 respectively). These areas specifically taught in the CUES-Ed programme as they are all known to positively impact on emotional well-being.

  • Children reported being significantly better able to cope when they felt sad (p<0.001) and angry (p=0.005).

Improved emotional literacy

  • Children were significantly better able to discriminate thoughts, feelings and behaviours (p=0.009).
  • Children were significantly better able to spot clues as to how they themselves, or someone else, might be feeling (p=0.03)

Increase repertoire of coping strategies

  • Children were significantly more likely to use helpful coping strategies and CUES-Ed specific coping strategies to solve problems (p=0.012).

Increased mental health awareness

  • Children were significantly less likely to use stigmatising language and more likely to choose positive language to describe the expression of emotions after CUES-Ed (p<0.001).

Normalised responses to confusing or difficult situations

  • Children were significantly better able to spot cognitive biases, such as jumping to conclusions, when presented with a confusing or difficult situation (p<0.001).

Qualitative feedback

  • 93% of children felt that CUES-Ed has helped them.
  • A thematic analysis of written evaluations showed the majority of children reported improvements across different areas after CUES-Ed (Table 1).
  • Teachers reported that they have learnt how to discuss mental health effectively with the children, and that the children are more aware of their emotions and strategies to solve emotional difficulties. They also reported that they will continue to use CUES-Ed strategies in the classroom.

Themes identified by children as useful

Increased repertoire of coping strategies

  • Relaxation techniques; behavioural techniques to improve mood; strategies for managing feelings of anger and frustration

Increased knowledge

  • Understanding links between physical and emotional wellbeing; understanding confusing or difficult experiences

Increased use of cognitive strategies to manage emotions

  • Use of positive self-talk; noticing thinking traps; ‘catching thoughts’

Improved emotional regulation

  • Improved in concentration; improved feelings of sadness anger and worry

Improved relationships

  • Improved friendships; able to manage family difficulties, able to support family and friends with feelings of sadness, anger and worry