Community-based activities and young people’s wellbeing

Summary

This evidence summary examines how community-based interventions can support young people's social and emotional wellbeing. Due to a scarcity of robust evaluation and reporting taking place across the sector, we selected a wide-range of materials for this review, including systematic reviews, relevant individual studies and case studies from UK-based organisations. Studies examining a range of different children’s and young people’s interventions were selected, with most aimed at improving social skills, emotional wellbeing and behavioural difficulties.

Introduction

This evidence summary seeks to address the following question:

What community-based interventions have been effective in supporting young people's social and emotional wellbeing?

About the evidence presented below

We drew on a wide range of evidence, including academic research in the fields of psychology, public health and social work in relevant databases (e.g. ASSIA, Campbell Systematic Reviews, CINAHL, ProQuest Public Health Database, PsycINFO, SCIE Social Care Online, etc.), on Google Scholar, as well as the websites of key organisations (e.g. the Early Intervention Foundation, YouthLink Scotland, etc.) and groups providing community-based activities (e.g. Sistema Scotland, Rhythmix, etc.).

The search looked at both children’s and young people’s interventions focusing primarily on those addressing social, emotional and behavioural difficulties, with particular attention paid to services for individuals with Autism Spectrum Disorder (ASD). Sources were limited to out-of-school interventions, however there is a strong body of evidence looking at school-based interventions and after school programmes for social and emotional wellbeing, particularly within the US context.

A common theme in the evidence examined for this review was that there was a lack of robust evaluation taking place across the sector. Quite often, there is a focus on certain indicators that are easiest to quantify, which may fail to capture the true value of services. The National Youth Work Strategy (2014) identifies measuring impact as a key priority for services working with young people, with the policy emphasising an ambition “to develop the capacity of the sector to be able to demonstrate how youth work improves young people’s wellbeing, life chances and outcomes”. More research is required on effective methodologies for capturing these outcomes.

Accessing resources

We have provided links to the materials referenced in the summary. Some of these materials are published in academic journals and are only available with a subscription through the The Knowledge Network with an NHSScotland OpenAthens username. The Knowledge Network offers accounts to everyone who helps provide health and social care in Scotland in conjunction with the NHS and Scottish Local Authorities, including many in the third and independent sectors. You can register here. Where resources are identified as ‘available through document delivery’, these have been provided to the original enquirer and may be requested through NHS Scotland’s Fetch item service (subject to eligibility).

Background

Young people with social, emotional and behavioural difficulties often struggle with traditional schooling, leaving them at risk of social exclusion with negative long-term consequences for their future social engagement (Thompson and Tawell 2017). Children who experience social challenges may struggle to interact with others according to social convention, which can affect both academic and social development (Rao et al. 2007). In addition to this, adolescence is a time of vulnerability to the risks associated with feelings of isolation from peers, such an increased risk of depression, and poor self-esteem (Hall-Lande et al. 2007).

Certain groups are more likely to experience social exclusion, such as young people with Autism Spectrum Disorder (ASD) (Orsmond et al. (2013), as a result of the communication and social interaction difficulties that are core characteristics of ASD (Deckers et al. 2017). Because the majority of young people with ASD are fully included in the regular classroom, they face unique social pressures and demands (Rao et al. 2007). Schools often lack the time and resources to support development of psychological and emotional skills like self-regulation, resilience and relationship skills (Thompson and Tawell 2017), presenting an opportunity for community-based groups to address this gap.

Clarke et al. (2015) found promising evidence that participation in out-of-school programmes offering creative and sport-based activities may increase young people’s social and emotional skills, in particular self confidence, self efficacy and emotional regulation. Other programmes report similar outcomes (Hampshire and Matthijsse 2010; Harkins et al. 2016; Thompson and Tawell 2017), however lack of rigorous evaluation presents difficulties in determining the reliability and validity of these findings. However, Hampshire and Matthijsse (2010) also found that improvements in emotional and social wellbeing did not extend to all children, with some facing disengagement as a result of their participation.

Specific groups of children and young people experience barriers to accessing community-based activities, with Tint et al. (2017) finding that a large proportion of caregivers of youth with intellectual disabilities (both with and without ASD) cite the cognitive demands of community activities and the lack of appropriate or available programmes as barriers to their children’s community participation. Tint et al. (2007) also found that there is some evidence that teaching social skills can improve social behaviours in youth with ASD. The authors also found that interventions focusing on modifying aspects of an individual’s environment, such as programmes addressing stigma associated with ASD, also have significant potential to improve social outcomes.

Social skills training groups are thought to improve an individual’s social functioning by providing instruction on specific social skills in a group format that allows for immediate practice of the learned skills and immediate reinforcement for using the targeted skill (Reichow et al. 2012). While theoretical underpinnings (e.g. behavioural, social learning, cognitive or cognitive behavioural) may vary, the common goal of social skills training programmes is to teach specific interpersonal skills that enable participants to be more successful socially (Cook et al. 2008). However, opinions regarding the efficacy of these programmes are mixed. One issue that arises repeatedly in the evidence is that while participants may demonstrate these skills within the training environment, these skills are not necessarily applied to daily life (Williams White et al. 2007; Rao et al. 2008). Guivarch et al. (2017) found that social skills training relying on explicit or ‘didactic’ learning is less likely to be generalised to everyday life, with some children able to demonstrate problem-solving strategies but unable to apply them in a real world situation. Guivarch et al. (2017) state that groups relying on implicit or incidental learning, where young people are given opportunities to acquire social skills and apply them immediately in social situations, could enable better generalisation of acquired skills.

Evidence

Due to a scarcity of robust evaluation and reporting taking place across the sector, we selected a wide-range of materials for this review. The evidence summarised below includes systematic reviews, relevant individual studies and case studies from UK-based organisations. Studies examining a range of different children’s and young people’s interventions were selected, with most aimed at improving social skills, emotional wellbeing and behavioural difficulties. We also included a number of papers addressing interventions for Autism Spectrum Disorder (ASD).

Arts and sports-based interventions

Barry, M et al. (2017) A review of the evidence on the effects of community-based programs on young people’s social and emotional skills development. Adolescent Research Review, 3(1), pp.13–37 (Open Access)

This narrative synthesis reviews 14 community-based intervention studies conducted in the UK from 2004 to 2016, excluding interventions implemented with youth with a diagnosed mental, behavioural or physical disorder. The review found that the evidence from interventions aimed at increasing social and emotional skills through creative arts and sports-based activities in the UK is currently quite limited due to a lack of robust study designs and poor quality analysis. A small number of robust studies provided evidence of effectiveness in improving social and emotional skills, however the majority of studies provided limited evidence as a result of poor quality evaluations.

Although the review identifies that there is a wide range of innovative community-based youth programs in the UK, more research is needed to determine the immediate and long-term impacts of these interventions in supporting young people’s social and emotional skills development and wider health, educational and social outcomes. The authors also recommend newly developed programs be subject to rigorous evaluation before being brought to scale.

Bungay, H and Vella-Burrows, T (2013) The effects of participating in creative activities on the health and well-being of children and young people: a rapid review of the literature. Perspectives in Public Health, 133(1), pp.44–52. (Available with NHSScotland Open Athens username)

This rapid review of literature covered 20 papers exploring the effects of participating in creative activities on the health and wellbeing of children between 11 and 18 years, including research on music, dance, singing, drama and visual arts taking place in community settings.

The review found the majority of studies contained methodological weaknesses and limitations, however there were some consistencies in their findings. The evidence provides some indication that participating in creative activities could be a useful strategy for increasing levels of physical activity, as well as having the potential to address young people’s sense of self-worth and life skills, which suggests that participating in creative activities can have a positive effect on the wellbeing of children and young people.

Clarke, A et al. (2015) What works in enhancing social and emotional skills development during childhood and adolescence? A review of the evidence on the effectiveness of school-based and out-of- school programmes in the UK. A report produced by the World Health Organization Collaborating Centre for Health Promotion Research, National University of Ireland Galway. (pdf)

This review looked at 8 out-of-school youth arts and sports interventions in the UK covering an age range of 7 to 25 years, and found 3 of these produced significant positive outcomes using standardised measures. These were improvements in young people’s self esteem, confidence, emotional regulation, organisation and leadership skills. Additional improvements in young people’s social and emotional skills were reported across the remaining 5 interventions, however as these outcomes were self-reported, the reliability and validity cannot be verified. The authors recommend further testing of programmes using more robust evaluation methods and long-term follow up assessments.

Daubney, A and Daubney, B (2017) Rhythmix: Music in Mind evaluation. (pdf)

The aim of this evaluation was to develop evidence to support music making activities as a key element of education and social provision for children and young people with mental health issues, and looked at outcomes of the Music in Mind programme run by Rhythmix. The programme is offered in both residential care and community-based settings with participants aged between 11 and 18 years. The evaluation uses narrative data from a range of different sources and perspectives, including conversations with young people, written and spoken narratives and observations from support staff and parents. Further detail about data collection is not provided in this report, and it is difficult to determine exactly what outcomes were measured.

There is some indication that participation in the structured programme supported engagement with formal education and that musical collaboration facilitated the development of friendships. There were also signs of increases in self-confidence and resilience. The authors also claim that offering a safe environment provides opportunity for self-expression and creativity, and that music acted as a mood-regulator in some instances. A number of challenges were identified, with more work required to understand the barriers to initial and sustained engagement, particularly in community settings. The evaluation states that re-integration strategies are vital for young people returning to the programme after periods of absence. There were also challenges in deciding how best to appropriately record and report specific outcomes.

Hampshire, K and Matthijsse, M (2010) Can arts projects improve young people’s wellbeing? A social capital approach. Social Science and Medicine, 71(4), pp.708–716. (Available with NHSScotland Open Athens username)

In this study, researchers conducted 18 months of fieldwork with SingUp, a UK government-funded singing initiative for primary school-aged children, focusing specifically on social and emotional wellbeing as they relate to social capital. They employed a questionnaire survey and a series of related, open-ended interviews designed to measure components of social capital, which was administered to 41 SingUp children and a control group in three rounds. Unfortunately, the high turnover of children in the programme meant too few children completed multiple rounds and the authors were unable to conduct statistical analysis of changes.

Their findings suggest that while SingUp improved emotional and social wellbeing by providing opportunities to develop new friendships and self-confidence, these benefits did not extend to all children. For some children, participation in SingUp posed a considerable risk to wellbeing. Children from relatively less privileged backgrounds risked becoming disengaged from existing friendship groups by participating in a programme perceived to be ‘uncool’, while the more privileged participants experienced disconnect as a result of adding an extra activity to an already busy schedule. The recommendation from this study is to make more serious investment in finding out about the creative activities children already do to ensure arts initiatives are culturally meaningful and relevant.

Harkins, C et al. (2016) Hitting the right note for child and adolescent mental and emotional wellbeing: a formative qualitative evaluation of Sistema Scotland’s ‘Big Noise’ orchestral programme. Journal of Public Mental Health, 15(1), pp.25–36. (pdf)

This paper is a qualitative assessment of short- to medium-term impacts of participants’ mental and emotional wellbeing within Sistema Scotland’s Big Noise orchestral programme. Happiness and enjoyment was repeatedly and explicitly identified by intervention partners and by participants themselves. Security, belonging and relationships were also identified as outcomes of the programme. The intensive nature provided a degree of routine and structure to children’s time, particularly those with less well-structured home lives. Other benefits include pride, confidence and self-esteem, generated through developing musical competence.

The authors identify the need for further research to advance understandings of the pathways that could connect community-based music programmes with health and wellbeing outcomes.

Lubans, D et al. (2012) Review: A systematic review of the impact of physical activity programmes on social and emotional well-being in at-risk youth. Child and Adolescent Mental Health, 17(1), pp.2–13. (Available with NHSScotland Open Athens username)

This systematic review examines 15 studies reporting the effects of physical activity programmes, and found that these programmes have the potential to improve social and emotional wellbeing in at-risk or ‘disaffected’ youth. Disaffection is defined by the authors as a complex phenomenon that manifests in different ways, including disengagement from mainstream activities as well as disruptive or antisocial behaviour . Outcomes identified in the review include improvements in self-worth, self-concept, resilience and perceptions of alienation and self-control. However, more rigorous evaluations are needed, particularly long-term follow-ups to assess whether these benefits are sustained. In addition to this, there have not been sufficient studies conducted to determine which types of programmes are most suitable for various subgroups of young people.

Thompson, I and Tawell, A (2017) Being other: social and emotional development through the creative arts for young people with behavioural difficulties. Emotional and Behavioural Difficulties, 22(1), pp.18–34. (Available from the author by request)

This study looked at 11 students with social, emotional and behavioural difficulties aged 11 to 15 years who attended the Fresh Art 12 week creative flexi-school programme. Participants were observed by fieldworkers attending the sessions, who later interviewed the students. This enabled the researchers to build good relationships with the young people, however this method introduces a risk of interviewer bias. The authors found the programme offered young people a respite from a situation of conflict at school, freedom to play and experiment without fear of judgement or failure, and an opportunity to be introduced to positive images of themselves. This in turn appeared to increase self-esteem, self-confidence and resilience. One major limitation to this study was that no follow-up data were collected, and further research is needed to look at the long-term impact of this programme for young people.

Social skills training interventions

Cook, C et al. (2008) Social skills training for secondary students with emotional and/or behavioral disorders: a review and analysis of the meta-analytic literature. Journal of Emotional and Behavioral Disorders, 16(3), p.131. (Available with NHSScotland Open Athens username)

This review examined 77 studies conducted with secondary-age students with emotional and behavioural disorders, with findings clearly indicating that social skills training is an effective intervention. The authors found that two thirds of students with emotional and behavioural disorders participating in social skills training will improve, compared to only one third of those not receiving social skills training.

One finding worth noting is that the effects of social skills training depend on the age or developmental period of the target group, with both preschool children and adolescents responding better than primary-age children. The authors suggest this could be because many social skills training programmes for this age group are not appropriately matched to the developmental level, or a result of resistance to efforts caused by the early onset trajectory of behavioural problems.

Rao, P et al. (2008) Social skills interventions for children with Asperger’s syndrome or high-functioning autism: a review and recommendations. Journal of Autism and Developmental Disorders, 38(2), pp.353–361. (Available with NHSScotland Open Athens username)

This paper reviews 10 articles examining social skills training interventions for youth with ASD, and found that 7 of these papers reported positive treatment effects, although these were sometimes limited to a subset of participants or outcome measures. Some of the limitations around measuring the efficacy of social skills training include a lack of a common definition of social skills, the effects of maturation and time over the course of treatment and difficulties for participants to generalise the skills they learn in settings external to the training environment.

Reichow, B et al. (2012) Social Skills Groups for People Aged 6 to 21 with Autism Spectrum Disorders (ASD). Campbell Systematic Reviews. (pdf)

This paper analyses five randomised control trials evaluating the effects of social skills groups in 196 participants with ASD aged 6 to 21 years old. The results show there is some evidence that social skills groups improve overall social competence, confidence and friendship quality. However, due to the nature of both the intervention and the outcome measures, the risk of bias is high and there is limited generalisability from the study. There is a need for further research using rigorous methods to measure outcomes and to understand the groups who will benefit most from social skills group interventions.

van Vugt, E et al. (2013) Evaluation of a group-based social skills training for children with problem behavior. Children and Youth Services Review, 35(1), pp.162–167. (Available with NHSScotland Open Athens username)

This study looked at a group-based social skills programme targeting problem behaviours in 161 children between 7 and 13 years of age. The findings show the effects of social skills training for children are only moderate and largely dependent on the type of problems present in participants. Both the experimental and the control group in this study showed small to moderate improvements in social and internalising problems, while a small and positive change in social anxiety was found only in the experimental group.

The authors also suggest that interventions targeting mixed groups are more effective than those targeting relatively homogenous groups where children may reinforce problem behaviour. The social skills training used in this study was a multi-component programme including social skills training, psychical education and mentoring, making it difficult to establish which of these components is responsible for the change in behaviour. It is plausible to suggest that it is a combination of these varied components that lead to the desired change.

Case studies

Community Learning and Development Managers Scotland (2013) Case studies of community learning and development in action. (pdf)

These cases were gathered from community learning and development services and providers across Scotland, described as “good” but “not necessarily exceptional” examples of practice. The authors note that evidence about the effectiveness of such programmes can come from many sources, such stories from participants, monitoring of key indicators and measuring shorter term impacts on wellbeing. The organisations focusing on young people include:

The Bonhill Youth Action Group project to address wilful fire-raising involved 12 to 16 young people aged 12 to 19 years, with older participants acting as peer educators for the younger members. The group created an anti-fire raising video over the period of 7 months. Partners believe the filming and subsequent distribution of the video resulted in a significant increase in awareness of fire-raising. The group also increased memberships and participants reported developing skills relevant to future employment, as well as a sense of satisfaction for making a difference to the community.
The Dunedin Canmore Youth Project led by Dunedin Canmore Housing provided new activities for young people in the form of two youth cafes, a volunteering project, a youth forum and an employability project. One of the key benefits identified in the case study was the opportunity for young people to build relationships and spend quality time with responsible adults in a safe environment. In addition to this, the housing association reported a reduction in minor repairs and complaints, which could be linked to a decrease in anti-social behaviour.

Interest Link Borders (2015) Children and young people’s project case studies 2014-2015. (pdf)

These case studies were collected from across the branches of Interest Link Borders, detailing the stories of 8 young people aged between 9 and 23 years. This organisation provides volunteer befriending for people with learning disabilities and their carers, including befriending groups and overnight trips. The outcomes reported from the participants and their careers include increased confidence, enjoyment, a chance to develop friendships, improved behaviour and the development of social skills.

Scottish Government (2010) Making an impact: CLD case studies. (pdf)

The outcomes from a number of different community learning and development organisations for young people are summarised in this report. The organisations are as follows:

Kemnay Peer Education Project in Aberdeenshire is an over 16s support group offered as a part of a youth cafe. Participants are young people with behavioural issues who develop and deliver workshops on issues that are important to them for other children and young people. Some of the reported outcomes of these programme were increased confidence, as well as improved communication skills and ability to engage with the local community. Members also developed negotiation skills, attended meetings, gave presentations, helped with training and became accustomed to sharing ideas with one another.
Stramash, Oban, Argyll and Bute provide an outdoor learning and activity programme for young people, including those who have experienced ‘disruption and trauma’. Young people, parents and local social workers report participation has a ‘very positive effect on the lives of young people’ by exposing them to experiences they wouldn’t otherwise have access to. The organisation reports that 80% of participants move on to a ‘positive destination’, such as further education. Other benefits include providing an opportunity to ‘get away from everything’ in a completely different, relaxing environment, a chance to mix with other young people and the opportunity to develop confidence and independence.
Pupil Intervention Project (PIP), Hawick, Scottish Borders offers nine weekly half-day sessions focusing on challenging behaviour and is attended by high school students who had experienced temporary school exclusion. Key benefits of the programme include reintegration into mainstream schooling and parents reporting increased harmony at home. The project also offers positive experiences for participants and reports improvements in self-esteem.
Explore, Dundee provides “intensive youth work” for participants aged 10 to 18 years. Young people involved in the programme identify areas in their life for support and work one-on-one with youth support workers and peer mentors several times a week for up to a year. Some reported outcomes include improved behaviour, re-engagement with school and onward movement to training, further education and employment. Young people are given the opportunity to attend a range of activities, some of which offer national and local accreditation of achievements.

Turtle Key Arts (2015) Key Club report vox pop. (Vimeo video)

In this short video, members of a creative arts and social club for young people on the autism spectrum discuss the positive impacts of the programme. Some of the common themes in this video include the development of independence, confidence and communication skills, as well as the opportunity to be creative. Most of the individuals featured in the video have been long-term members of the group.

References

Barry, M et al. (2017) A review of the evidence on the effects of community-based programs on young people’s social and emotional skills development. Adolescent Research Review, 3, pp.13–37. (Open Access)

Bungay, H and Vella-Burrows, T (2013) The effects of participating in creative activities on the health and well-being of children and young people: a rapid review of the literature. Perspectives in Public Health, 133(1), pp.44–52. (paywalled)

Community Learning and Development Managers Scotland (2013) Case studies of community learning and development in action. (pdf)

Cook, C et al. (2008) Social skills training for secondary students with emotional and/or behavioral disorders: a review and analysis of the meta-analytic literature. Journal of Emotional and Behavioral Disorders, 16(3), pp.131–144. (paywalled)

Daubney, A and Daubney, B (2017) Rhythmix: Music in Mind evaluation. (pdf)

Deckers, A et al. (2017) Being on your own or feeling lonely? Loneliness and other social variables in youths with autism spectrum disorders. Child Psychiatry & Human Development, 48(5), pp.828–839. (Open Access)

Guivarch, J et al. (2017) Impact of an implicit social skills training group in children with autism spectrum disorder without intellectual disability: A before-and-after study. Plos One, 12(7). (Open Access)

Hall-Lande, J et al. (2007) Social isolation, psychological health, and protective factors in adolescence. Adolescence, 42(166), pp.265–286. (paywalled)

Hampshire, K and Matthijsse, M (2010) Can arts projects improve young people’s wellbeing? A social capital approach. Social Science and Medicine, 71(4), pp.708–716. (paywalled)

Harkins, C et al. (2016) Hitting the right note for child and adolescent mental and emotional wellbeing: a formative qualitative evaluation of Sistema Scotland’s ‘Big Noise’ orchestral programme. Journal of Public Mental Health, 15(1), pp.25–36. (pdf)

Interest Link Borders (2015) Children and young people’s project case studies 2014-2015. (pdf)

Lubans, D et al. (2012) Review: A systematic review of the impact of physical activity programmes on social and emotional well-being in at-risk youth. Child and Adolescent Mental Health, 17(1), pp.2–13. (paywalled)

Orsmond, G et al. (2013) Social participation among young adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(11), pp.2710–2719. (paywalled)

Rao, P et al. (2008) Social skills interventions for children with Asperger’s syndrome or high-functioning autism: a review and recommendations. Journal of Autism and Developmental Disorders, 38(2), pp.353–361. (paywalled)

Reichow, B et al. (2012) Social Skills Groups for People Aged 6 to 21 with Autism Spectrum Disorders (ASD). Campbell Systematic Reviews. (pdf)

Scottish Government (2010) Making an impact: CLD case studies. (pdf)

Scottish Government (2014) Scottish National Youth Work Strategy 2014-2019. (pdf)

Tint, A et al. (2017) Community participation of youth with intellectual disability and autism spectrum disorder. Journal of Intellectual Disability Research, 61, pp.168–180. (Open Access)

Thompson, I and Tawell, A (2017) Being other: social and emotional development through the creative arts for young people with behavioural difficulties. Emotional and Behavioural Difficulties, 22(1), pp.18–34 (paywalled)

Turtle Key Arts (2015) Key Club report vox pop. (Vimeo video)

van Vugt, E et al. (2013) Evaluation of a group-based social skills training for children with problem behavior. Children and Youth Services Review, 35(1), pp.162–167. (paywalled)

Williams White, S et al. (2007) Social skills development in children with autism spectrum disorders: a review of the intervention research. Journal of Autism and Developmental Disorders, 37(10), pp.1858–1868. (paywalled)