Supporting SEMH needs: implementing a graduated response

In this week's article, we are exploring practical ideas for implementing a graduated response to social, emotional and mental health needs, which includes ideas for universal, targeted and specialist strategies to help you to create a whole school approach as well as support you to develop your response for students with identified social and emotional wellbeing needs.

Spotlight Guidance: Mental Health and Behaviour in Schools

"When schools suspect that a [student] is having mental health difficulties, they should not delay putting support in place, using the graduated response process

• an assessment to establish a clear analysis of the [students] needs
• a plan to set out how the [student] will be supported
• action to provide that support
• regular reviews to assess the effectiveness of the provision and lead to changes where necessary.

This can happen whilst the school is gathering the evidence and the students response to that support can help further identify their needs."

My recommended tool for identifying needs (assess) and measuring outcomes (review) is the Strengths and Difficulties Questionnaire (SDQ). Click here to read my article on the SDQ. See below for a free course on using the SDQ.

"In addition to informing decisions on whether to seek specialist support, they can also provide a basis for ascertaining whether the initial intervention is working or whether something different needs to be tried."

Not all children with mental health difficulties will have SEN. But persistent or serious mental health difficulties will often meet the definition of SEN, in that they lead to [students] having significantly greater difficulty in learning than the majority of those of the same age.

Source: Paragraph 3.25, Mental Health and Behaviour in Schools (DfE, 2018)

"The graduated response process, set out in the SEND Code of Practice (DfE DoH, 2015) provides a framework for deciding what support to offer, which would be good practice regardless of whether or not a student has a special educational need."

Practical ideas for implementing a graduated response to social, emotional and mental health needs

Universal (for all students)

Every teacher is a teacher of SEND and every student should have access to Quality first teaching.

Quality First Teaching is a style of teaching that emphasises high quality, inclusive teaching for every student, which includes differentiated learning, strategies which are effective in supporting students with SEN learning in school and ongoing formative assessment, to name a few examples.

In any learning environment, it's important to have a system in place that addresses the social, emotional and mental health needs of all students.

A graduated response to SEMH involves a range of strategies that aim to support students in a holistic manner.

• One key element is having a designated adult within the setting who can build positive relationships with students and provide daily check-ins, such as a class teacher or form tutor.
• This person can also help implement meaningful reward systems that involve regular monitoring and support.
• Another important aspect is ensuring that all team members are aware of students' needs and are equipped to provide appropriate support.
• This includes recognising the emotions behind students' behaviours and providing coaching to help them regulate their emotions.
• To create a safe and supportive learning environment, it's important to provide a quiet and calm space where students can go to regulate their emotions.
• This space should be supported by adults who can help students problem-solve and restore themselves to a place of emotional balance.
• Visual supports can also be helpful in identifying and naming emotions and frequent verbal reassurance and positive feedback can help students feel supported and valued.
• To ensure that all students have access to the curriculum, quality first teaching should be planned and communicated clearly.
• Varied group and personalised learning strategies can help maintain connections with individual students and ensure understanding.
• Differentiation across the curriculum, with supporting materials to increase engagement and build success, is also important.
• Modifying the level, pace and amount of teacher talk can help students feel more engaged and supported.
• The curriculum itself should also be varied in content, including activities such as play, mindfulness, physical regulation and PSHE.
• Consistent class rewards, boundaries, routines and language can also help create a positive and supportive learning environment for all students.

Targeted (for some students with identified needs)

In a learning environment, it's important to have targeted support in place for students with identified social, emotional and mental health needs.

This can involve a range of strategies that aim to provide the necessary support for these students.

• One important element of this approach is having regular emotional check-ins and reassurance from key adults throughout the school day.
• It's also important to provide students with daily access to adults who have experience with SEMH and are committed to building positive relationships.
• Daily mentoring and age-appropriate play-based activities can help build positive attachments and relationships, while an emotionally available adult can help co-regulate emotions and provide a safe base to calm and regulate.
• Sensory breaks, brainstem calmers and physically repetitive sensory activities can also be helpful in relaxing and calming students with social, emotional and mental health needs.
• It's also important to have regular support and discussion with the SENDCo to ensure evidence of need is secured from all key adults supporting or involved with the student.
• To ensure that these students have access to the curriculum, increased access to a combination of individual, small group and whole-class activities based on emotional needs can be provided.
• One-to-one support for new concepts and reinforcement of classroom routines can also be helpful.
• At least weekly sessions focused on identified and assessed SEMH needs with a trained therapeutic adult should also be provided.
• Consideration of an alternative differentiated curriculum that allows flexibility to teach according to emotional needs can also be helpful.
• Fixed sessions for alternative activities, which are not reward-based but allow for emotional breaks for enhanced wellbeing, can be provided.
• Bespoke reward systems for positive engagement, developed language for motivating students around their values and interests and phased or chunked learning with visual "Now and Next" can also be helpful.
• Finally, varied methods for securing progress and evidence of learning for these students can be provided, such as photos, video logs, art or games. This ensures that they can engage with the learning process and feel supported in their academic progress.

Specialist (for few students with significant needs)

For students who require

• Providing increased access to smaller group provisions such as nurture or social skills groups can help students feel more supported and build their confidence.
• Having support in place for unstructured times such as break times and lunch times can also be beneficial for students.
• Team members can actively engage and share time with students during unstructured times, offering physical regulation and bonding through play activities.
• Offering some opportunities for alternative provision, such as Forest School or outdoor kitchen play, can provide a refreshing change of pace and help students reconnect with nature.
• Providing mentoring and supervision to support the wellbeing of the team and establish a network of secure support can also help create a supportive environment for students.
• It can also be helpful to teach a personalised, differentiated curriculum adapted and reviewed regularly to meet individual needs while providing additional SEMH support from emotionally available adults in most lessons.
• SEMH interventions can be structured around interests and flow activities and guided by assessments to provide structure and progress.
• Daily "check-ins" in a calm environment to regulate across the day with an empathetic, emotionally available adult, as well as timetabled SEMH sessions in either small groups or 1:1, including social skills groups, can be helpful.
• Providing structured opportunities in specific nurturing or sensory environments that can soothe and regulate can also help students thrive while extending the focus of support to include secure caregivers can create an even more supportive environment for the student.

Spotlight Resource: Derbyshire Graduated Response

For every article, I spotlight a resource that is relevant and useful for other professionals and practitioners can access to influence and improve their professional practice. Derbyshire County Council , through their Local Offer, have published a really useful and practical guide to a graduated response, covering all areas of SEND, including SEMH.

Want to take a read? Click here to access the document.

Spotlight CPD: Strengths and Difficulties Questionnaire (SDQ)

Looking for a tool to measure the social and emotional wellbeing of the children you support? Why not book a space on a popular course I lead for the Mental Health Hub, designed to empower you with the tools and strategies to implement wellbeing measurements? Click here to see our upcoming dates.

The most important thing to remember is to take action.

All the information in the world won't make a difference unless you put it into practice!

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