Face to Face Evidence, impact and evaluation
We developed Face to Face to help children in care cope with any problems they may face now or in the future. The evidence so far suggests that Face to Face can contribute to improved wellbeing for children and young people in, or at risk of being taken into, care.
How being in care affects children
There are over 93,000 children in care in the UK. The majority of children and young people enter care as a result of abuse or neglect.
For these children, care is a vital part of our child protection system. It can help children by providing protection and the chance to rebuild their lives. But further support is needed to help these children and young people overcome the effects of the abuse and neglect they have suffered.
Read more about children in care.
How Face to Face is helping protect children
Children in care are at greater risk of experiencing poor emotional wellbeing than children in the general population.
Looked after children and young people have much higher rates of mental health difficulties than the general population. Almost half of children in care (and three quarters of those in residential homes) meet the criteria for a psychiatric disorder (Ford et al, 2007; Meltzer et al, 2003).
Children and young people in care told us that they wanted a confidential service that they could access quickly, that was face-to-face and on their terms. So, we developed Face to Face.
It aims to help young people by using a solution-focused approach to improve their confidence, skills and strengths so they're better prepared to cope with problems now and in the future.
How we're evaluating this service
We used a mixed-method design to measure changes in well-being for children and young people in the care system and at risk of coming into care.
We have also assessed the changes for children and young people 3 months after delivery to see if improvements in their well-being were sustained over time.
Key primary outcomes of the service were measured using the Outcome Rating Scale (ORS). The ORS was used at the beginning of every session and three months after finishing the programme (T3). The quantitative evaluation sample consisted of 611 children who had completed the Face to Face work, including a 3-month follow-up with 103 children.
We interviewed 18 children who completed Face to Face service as part of the process element of the evaluation. The interviews explored the service users' experiences and helped identify underlying facilitators and barriers to the programme bringing about change for parents and children.
We interviewed 10 foster carers and referrers to explore their experiences of referring children to the service and get their feedback on what change they had seen in the children and young people.
18 NSPCC practitioners who deliver Face to Face also participated in 3 focus group discussions, providing an insight into their perspectives on the outcomes that the programme achieves.
Ensuring that young people were able to see their rating on the Outcome Rating Scale (ORS) as a reflection of the progress they were making was a particular challenge. To overcome this, we incorporated the ORS evaluation tool into the practice model. Practitioners from the Lincolnshire Child and Adolescent Mental Health Services (CAMHS) Partnership Trust also supported teams through workshops about using the ORS in their practice.
This evaluation was carried out internally by the NSPCC evaluation department. It used the following tools:
- The Outcome Rating Scale (overall psychological distress)
- Questionnaire at the end of the service
- Questionnaire at the 3 month follow up
Contact Matt Barnard for more information.
What we've learnt so far
Our findings provide promising evidence that Face to Face can contribute to improved wellbeing for children and young people in, or at risk of being taken into, care.
Of the children who were most in need at beginning the service - those with clinical levels of distress - 70 per cent showed reliable improvement and ended the service with normal levels of wellbeing.
Read the evaluation report.
What we're doing next
We have produced a toolkit of resources for practitioners who want to use a solution-focused approach to improve outcomes for vulnerable children and young people.
We have also produced an implementation guide for those who are interested in setting up a service like Face to Face.
Impact and evidence hub
Find out how we evaluate and research the impact we’re making in protecting children, get tips and tools for researchers and access resources.
Support our services
Our services help children and families who need support. With your help, we can make sure even more children are safe from abuse.
Find out more
Achieving emotional wellbeing for looked after children: a whole system approach
Solution-focused practice toolkit
Emotional wellbeing and mental health
Ford, H. (2006) Women who sexually abuse children. Chichester: Wiley.
Meltzer, H. et al. (2003) The mental health of young people looked after by local authorities in England (PDF). London: The Stationery Office (TSO).