 I'm here with Rick, we're at a self-harm conference and Rick has been talking about the morning body programme, can you just introduce a little bit about what the programme is, who you are, what you do? Yeah sure, so morning body is a programme delivered by our action and we are commissioned at the moment that Kent calls to work with young people around self-harm, so we work with 13 to 17 year olds who are either involved in self-harm behaviours or might be involved in that too. I guess the core of the programme is really delivering group sessions, so we have one-to-ones initially with young people just to check their levels of risk and how they might be for that type of programme because it really needs more intervention. But from that point on young people then take part in a group sessions in terms of where they can hopefully talk in a really safe space, maybe for the first time about mental health and maybe about some of the treatments for self-harm and how to manage those. Why did you choose group intention? To be honest we didn't necessarily choose it, it started to choose itself because when we started the programme back in 2014 we piloted the programme in both one-to-one and group settings but the feedback that we had from young people was that they really liked the groups and to hear from others, to hear from their peers and get that comfort that they weren't the only people going through these things was hugely powerful. So for that reason it's become the real selling point of the programme. You have to manage it very carefully so when we are putting groups together I guess what we have to make sure is that you don't have different levels of risk within the same groups. Can you say a bit more about that? So what we wouldn't want is maybe somebody who is involved in self-harm and has maybe been for quite a long period of time and their level might be quite a high level of risk. You wouldn't want somebody there in the same group who is maybe at a lower level struggling a little bit with anxiety, who might be a bit more impressionable and where things could potentially, you might be almost bringing their behaviours up if that makes sense. So we're very cautious about having people on the programme where there is sort of complex risks, where there is sort of enduring behaviours that are quite embedded. And how many people would be in a group? We'd look at five or six as the average saying you've got a bit of safety in numbers but also it allows enough opportunity for people who want to speak to have their voice heard. And how long does each group run for? So the sessions are an hour and the way that the programme works is after the initial one to one they will then take part in six group sessions over a roughly period of a month. So maybe one or two sessions a week we then have another one to one after that first block of sessions. And then there's a gap for maybe two months and over that time the idea is that the young people can employ those strategies and techniques, stuff that they've learnt in the groups, they can hopefully manage themselves over a period. They come back together for two final review and reflection sessions, see how they're getting on, what's working, what maybe could they do better, sharing ideas again between themselves and then have an exit one to one. I guess what's been the core success is that we've seen that improvements take place from the first one to one to the second one but even more so at the exit. Wow, so they're not even receiving the intervention anymore, they're just employing those strategies? Yeah, so they've had just two sessions in the space of maybe two to three months but because they've learnt the different ways of managing triggers to improve communication, all of those strategies either themselves or with those peers are in the group, the outcomes at the end are even better. Can you explain a bit more about the actual content of the group sessions, so what are these kids actually learning, what are they doing? Yeah, so the first session is really very general so it might be exploring mental health just as an overarching topic and how people feel that they are able to speak with peers and things, to speak with friends, to speak with family. Are there some topics that they think are quite taboo and as the programme goes on you maybe start to look a little bit more at their individual behaviours. Again, not going to the levels that would be required in the ones ones but looking maybe at some basic triggers and how to manage those triggers. So positive distractions and diversions, they share ideas around that, there's a lot of stuff about communication. But it's all geared towards empowering them to manage themselves in a more positive way rather than allowing them a practitioner. I think one of the core things that we've found from the research is that young people are able to do that and it's great for themselves but what they've also got is then a role in supporting others. And so if you have that transition from somebody who's maybe never spoken previously about struggling with mental health to being in a place where they're actually a support mechanism for other people, that's a massive step. And what happens after this finishes because surely these young people become quite close and they are quite good support network for each other, does that continue beyond? In some schools it definitely does so we know that some of them might have continued meetings in schools where the pastoral teams have allowed them to ok you can meet in this room and just keep things going, maybe they do art projects together or something like that. Others maybe just might be a Whatsapp group or something where they can just link in and they have that support. And it can be quite informed I suppose that it's just that they pass each other in the corridor and they just have a little check-in just to know that they're in somebody else's thoughts. That's a really powerful thing. And what about the person who leads the group? What kind of person can lead this kind of group and what are the measures that you have to put in place to make sure that they're kind of safe and well prepared? So we've got in terms of the practitions we've got a real range, so some who have come from mental health especially as backgrounds but a lot of our workers have them so they might have come from pastoral teams, maybe sort of working with other vulnerable groups. The core thing that we look for in any work is that they can engage with a young person and there's somebody that a young person would feel comfortable talking to. So that's more important than their kind of great long CV, you're looking for someone who can guess? Yeah, it's really hard to learn how to talk to a human being, I think. If they have that as a natural skill obviously there's all the induction work that goes with it. There's the training package, all the practitions have regular clinical supervision on a one-to-one group basis, there's all that professional development as well that we've put in place for them. What you can't really learn though, you can always build on them but I think those natural engagement tools are very difficult and we're lucky that we've got in each area, we've got great staff teams who are passionate about what they do and they're getting fantastic outcomes with the young people that they're working with. I'm thinking about people who are watching this who maybe might not have access to the mind and body programme but might be thinking about setting up something similar themselves on a local basis. What would be your kind of, I don't know, do's and don'ts? The do's is I think thinking about evidence base which might sound like a really dull thing to say but I think it's really important on a topic which you do need to handle very carefully that you're not going in there with the best of intentions but perhaps causing more harm than doing good. So it's about, you've got things like the Anna Foyd centre, we've got a good list of evidence-based programmes, a mind and body is listed on the Cape repository, the Centre for Analysis of Youth Transitions. So there is a lot of stuff out there, I'm a fan of mind and body but I'm slightly biased. But there are lots of programmes out there that show how to do evidence-based interventions. I guess we've mentioned things like the CYP Mental Health Coalition, I'm sure would be another good starting point for people. But I would say don't be afraid to give young people a space to talk, don't worry, don't worry too much about mentioning the idea of contagion when actually if you speak to a young person about self-harm, something they can start doing it or if they else will. I think as long as you are careful in managing it and checking in with them as they have their own supervision to make sure that they are safeguarded and what they're doing is appropriate, then we really need to encourage open discussion about mental health and group settings we have found out are a great way of doing it. So you're basically encouraging but making sure that people do it within kind of safe parameters? Yeah, and if anybody wants to get in touch with me about how we work then I'm always very happy to sort of drop a little bit. Great, we'll put links to the programme all down below and who can actually access the programme because some people watching this could access. Yeah, so at the moment we're commissioned in Cornwall in Kent, we've piloted the programme successfully in Lancashire and we're looking at building it up there. We're now at a stage, to be honest, where the programme has been evidence-based. We would like to move it into other areas so for another commission as well to get in touch. But yeah, for those young people if you just go on to our actions website, the Google Add Action mind-boggling you'll be able to find out the details. Okay, we can put that all in the video details as well. Great, well thank you so much. Thank you. Yeah, good luck with, I don't know, I'm rubbish at ending videos. I don't know, maybe we just wave and smile just hands.