The Intensive Intervention Programme

The development and expansion of Intensive Family Intervention Projects (IIPs) was a key element of early intervention, whole family and family-centred approaches, and complemented a range of other initiatives. The Youth Task Force Action Plan made a commitment to establish twenty Intensive Intervention Projects (IIPs) delivered by both statutory and third sector providers (Department for Children, Schools and Families, 2008). These projects aimed to turn around the lives of up to one thousand of the most challenging and problematic young people aged eight to nineteen each year from April 2009 to March 2011, and were based on a key worker model and located within strong multi-agency partnerships. The projects were expected to significantly reduce anti-social behaviour, reduce crime, improve participation in education and training, tackle substance misuse and reduce homelessness. However, other risk factors were identified: teenage pregnancy and young parents, challenging family backgrounds, poor aspirations and living in poor neighbourhoods and/or poverty (Department for Children, Schools and Families, 2009a).

Policy context

Policy rhetoric over the last decade has focused on vulnerable families and social exclusion. A key aim of both the previous Labour and current Coalition government is early intervention, taking a whole-household approach (Department for Children, Schools and Families, 2009b; Department for Children, Schools and Families, 2010a, b, c; Hughes, Reference Hughes2010; Loveless and Hickling, Reference Loveless and Hickling2010) which was highlighted in Every Child Matters (HM Government, 2004), and various other strategies focusing on young people and families (Cabinet Office, 2007; Department for Children, Schools and Families, 2007, 2008; HM Government, 2009). During the late 2000s a range of programmes, driven by a holistic policy focus and bringing together a range of services, were established to deliver a suite of early interventions to the most vulnerable. Think Family Pathfinders (Department for Children, Schools and Families, 2010b); Targeted Youth Support Pathfinders (Palmer and Kendall, Reference Palmer and Kendall2009), Family Intervention Projects (FIPs), child poverty and youth crime (Respect Task Force, 2006) and challenge and support projects (Department for Children, Schools and Families, 2008) focussed on the most vulnerable families preventing poor behaviour from escalating. A single Early Intervention Grant drew together a range of funding streams and, alongside the Public Heath Grant, enabled local authorities to take a strategic approach to providing support to vulnerable young people and families (HM Government, 2010). Latterly, a series of reviews (Cabinet Office, 2010, 2011; Department for Education, 2011; Ministry of Justice, 2011) have contributed to the child poverty strategy A New Approach to Child Poverty: Tackling the Causes of Disadvantage and Transforming Families’ Lives, ‘at its heart are strengthening families, encouraging responsibility, promoting work, guaranteeing fairness and providing support to the most vulnerable’ (Department of Work and Pensions and Department for Education, 2011: 8).

Policy rhetoric has undergone a subtle shift under the Coalition government. In the wake of the riots of 2011, addressing the issues of troubled families was reinvigorated, continuing the policy focus on early intervention adopted under Labour. The Troubled Families Programme, launched in December 2011, takes a holistic approach to turning around the lives of 120,000 families in England by 2015, focussing on getting children back into school, reducing youth crime and anti-social behaviour and putting adults on a path back to work (Department for Communities and Local Government, 2012). Key themes within the government's approach include early intervention, multi-agency working, promoting the role of families, partners, carers and peers and expanding the role of non-state service providers (Ministry of Justice, 2010). Although support continues for the most vulnerable, questions remain about the effectiveness of such interventions; payment by results and a continued focus on hard outcomes underplay the learning and soft outcomes that are often a prerequisite to achieving the long-term effects that these programmes are designed to address.

Existing research evidence

Learning from these programmes and evaluations, in general, has suggested that there have been some positive impacts. A series of evaluation studies have been undertaken of Family Intervention Projects (FIPs)Footnote ¹ (Nixon et al., Reference Nixon, Parr, Hunter, Myers, Sanderson and Whittle2006; White et al., Reference White, Warrender, Reeves and La Valle2008; National Centre for Social Research, 2009; Dixon et al., Reference Dixon, Schneider, Lloyd, Reeves, White, Tomaszewski, Green and Ireland2010) and other similar projects (Dillane et al., Reference Dillane, Hill, Bannister and Scott2001; Scott, Reference Scott and Flint2006; Pawson et al., Reference Pawson, Davidson, Sosenko, Flint, Nixon, Casey and Sanderson2009; Local Government Leadership and City of Westminster, 2010; Renshaw and Wellings, Reference Renshaw and Wellings2010; Wright et al., Reference Wright, Gray, Watts, McAteer, Hazel, Liddle and Haines2010) designed to reduce anti-social behaviour, prevent cycles of homelessness and achieve the five Every Child Matters outcomes for children and young people. Overall, all were found to have been successful in a number of outcomes: family engagement; ‘considerable improvements’ in all key areas, including reduced risks of enforcement action, relationship breakdown and domestic violence; improved school attendance; reduction in anti-social behaviour; no longer being at risk of homelessness; and improvements in financial management. An early impact evaluation of the Think Families Pathfinders (Kendall et al., Reference Kendall, Rodger and Palmer2010), seeking to ensure that families at risk receive a whole family package of support, also found positive effects: reduced levels of need and a reduction across all risk categories, such as family violence, lack of family support networks, debt and housing status. The Targeted Youth Support Pathfinders had achieved positive changes in how professionals delivered support to vulnerable young people with improved knowledge, skills and behaviour of practitioners (Palmer and Kendall, Reference Palmer and Kendall2009).

A number of factors within this suite of interventions have been identified as being linked to positive outcomes, including independence, the combination of support and enforcement, flexibility, multi-agency working, a whole family and holistic approach and the quality and commitment of project workers (Barnes et al., Reference Barnes, Ball, Meadows, McLeish and Belsky2008, Reference Barnes, Ball, Meadows and Belsky2009; Palmer and Kendall, Reference Palmer and Kendall2009; Duffy, Reference Duffy2010; Duffy et al., Reference Duffy, Waters and Glasby2010; Simpson and Murray-Neil, Reference Simpson and Murray-Neil2010; Wright et al., Reference Wright, Gray, Watts, McAteer, Hazel, Liddle and Haines2010).

Research approach

This article draws on evidence assembled as part of an evaluation of the Intensive Intervention Programme between February 2010 and December 2011 (Flint et al., Reference Flint, Batty, Parr, Platts-Fowler, Nixon and Sanderson2011). The research focussed on capturing the nature of interventions and interactions between young people, parent(s)/carer(s) and the IIPs; identifying more immediate and fluctuating, rather than merely summative, outcomes; giving prominence to the views of young people, parent(s)/carer(s) and IIP workers; identifying the contexts, roles and functions of the IIPs; and identifying a range of soft outcomes, not simply those that were longer term, hard and quantifiably measurable.

Twenty IIPs participated in the programme. In selecting the IIPs, a range of criteria were utilised in order to achieve a balance in terms of: local authority or third sector delivery; geographical location and context; the age, gender and ethnicity of IIP users; the reported focus of interventions within each IIP; and the reported intervention methods, including the approach towards sanction and reward. In addition, consideration was given to IIPs which appeared to demonstrate innovation and/or reported successes and closed cases. In discussion with the Department for Children, Schools and Families, area leads and some IIP managers, the following five IIPs were selected as case studies: Birmingham Building Lives, Bolton IIP, East Sussex IIP, Gateshead Sungate IIP and Northampton IIP. Longitudinal case studies of fifteen young people comprising three young people each from five IIPs were undertaken. The rationale for this number of case studies and locating them in five IIPs was based on our understanding of the challenges involved in securing the participation of the young people, the support required from the IIPs to facilitate the research and the likely intensity of research activities that would be necessary. It should therefore be noted that the sampling of young people was based on an initial selection of IIPs, rather than direct sampling from the entire cohort of young people within the IIP national programme, and was largely driven by IIP project workers. Although attempts were made to ensure diversity in terms of age, gender, issues and needs and the focus of interventions, inevitably these decisions were strongly influenced by the circumstances of young people and their families, their engagement with the IIP, their willingness to participate and the appropriateness of their participation.

The purpose of the individual longitudinal case studies was to track young people's journeys during the IIP intervention. An initial visit was made, comprising a preliminary meeting with the IIP worker and analysis of the case files, followed by a meeting with the young person and their parent(s)/carer(s). The case studies were progressed through a series of semi-structured telephone interviews with the young person, their parent(s)/carer(s) and their project worker(s), for a twelve-month period. The interviews sought to establish the nature of the IIP interventions, perceptions of these interventions, changing circumstances and events and to track the journey of the young person and their families during the IIP interventions. A round of final reflective interviews was undertaken with the young people, their parent(s) and their project worker(s), either by telephone or face to face. These interviews sought to gather the perceptions of each of the stakeholders about the IIP intervention overall.

It is acknowledged that the approach was characterised by some of the limitations identified in previous critiques of evaluations of Family Intervention Projects (Garrett, Reference Garrett2007; Gregg, Reference Gregg2010) including very small sample sizes, sample selection bias, a reliance on the subjective perspectives of project workers and users, the lack of a control group and difficulties in identifying causality, outcomes and the longer-term sustainability of progress (for a full account of methods see Flint et al., Reference Flint, Batty, Parr, Platts-Fowler, Nixon and Sanderson2011).

The young people

This section summarises the issues that young people were facing and outlines individual interventions received during their engagement with the IIP. Pseudonyms have been used.

Jake, seventeen, engaged in criminal damage and anti-social behaviour, putting the family's tenancy at risk. He was verbally abusive and violent to family members. Jake participated in a number of one-to-one sessions and the use of a goals sheet encouraged him to be more aware of the needs of others and to take responsibility for his own behaviour. Later sessions introduced healthy eating, a responsibility for household cooking and undertaking shopping. A work placement with a local butcher was secured which Jake attended every day. He also received intensive support to apply for college places and a summer job in a local supermarket. He eventually secured a place at a local college where he could remain living at home.

Amy, Claire and Julia presented with a number of issues: vulnerability, low self-esteem, self-neglect and were at risk of engaging in criminal behaviour. Engagement with a film project encouraging participation and social interaction, allied with an intensive approach by IIP workers, enabled all three young people to improve their confidence and work towards positive behaviour.

The IIP worker had taken four months to establish an open and trusting relationship with Amy. Gentle persuasion and support was used to encourage Amy to mix socially and leave the house, initially through the film project. This led to a Youth Achievement Award which encouraged Amy to move on to college and a Connexions E2E course.

Julia was not attending school and engaged in criminal behaviour. She suffered emotional stress and self-harmed. Julia's circumstances changed in June 2011 when she became pregnant and moved in with her boyfriend. Her aspiration to attend college was deferred until she felt better equipped to attend.

Not all progress was positive or straightforward – Claire, despite playing several leading roles in the film project and undertaking a cookery and mechanics course, made little progress in attending mainstream school, continued to stay out overnight and became pregnant. Offering emotional support, often on a daily basis, was the main focus of latter support for Claire.

Eddie, Isaac, Robert and Kate presented with similar issues: anti-social behaviour, or at risk of committing it, were not in education and had complicated family circumstances. The use of one-to-one and anger management sessions and time for reflection ensured that Eddie, Isaac and Robert progressed positively with no further instances of offending and improved school attendance. However, despite making some initial progress, Kate received a Youth Rehabilitation Order.

Lenny, Ricky and Ronnie presented with a range of mental health issues, were not in education and were engaged in anti-social behaviour and criminal activity. Work with them focussed primarily on improving education attendance. In the case of Lenny and Ricky, referral to other services was undertaken, with encouraging outcomes. Lenny received a clinical diagnosis of learning and behavioural problems and special educational needs and secured a dedicated package of support from the Learning Difficulties Team, and Ricky accepted supported accommodation and started a vocational catering course jointly funded by Social Services and the IIP. Although Ronnie ceased his involvement in criminal behaviour, he was still involved with local gang members.

Ash, Steven and Tariq had been involved in gangs and drug use. They undertook a series of courses and projects involving boxing, gardening and drama, and received practical support with bus fares and completing college application forms. Crucially, one-to-one sessions were used as opportunities to build up trust and confidence and to encourage conversation. Tariq completed college application forms, Steven attended school sporadically and Ash was referred to Resettlement Aftercare Provision.

Daniel's case was unique. Two key workers taking a whole family approach were used to deal with the dysfunctional family circumstances. Close liaison with school and encouragement to attend parenting courses improved family circumstances for a short period of time. Despite all efforts, however, a serious domestic violence incident resulted in complete family breakdown.

Learning and soft outcomes

The role of key workers was a critical factor in bringing about soft outcomes and helping young people on their journey of progress. Key workers were viewed as: ‘good people who take me places and try to help me’ or ‘were doing things for my good’ and young people stated that key workers had ‘helped me stay on track . . . and stay out of trouble’ and ‘is good and keeps us out of trouble . . . and away from the wrong sort of people’. One young person believed that the key worker had ‘helped me change the way I behave’, another young person believed that the key worker had ‘helped turn me into an adult’.

One-to-one working and the persistence and consistency of support were the elements of support that featured most prominently in the accounts of young people, helping them to enhance their communication skills and improve relationships. However, group activities, referrals and practical assistance were also identified as being important aspects of the interventions.

The space and time to talk (Jeffs and Smith, Reference Jeffs and Smith2005) often resulted in a trusting relationship and was considered to be valuable and different to the approach of other services. One young person spoke positively about his key worker: ‘other people wouldn't take you to court and show any interest in stuff’. Another explained that the informal support from the key worker was more effective than the more formal and instructive support, which, although it would ‘make you get up and do things’, did not provide the same opportunities for conversation. A third young person appreciated the fact that the key worker was ‘always available to listen’. Young people also welcomed consistent contact by key workers ‘just to say how you been, what are you doing?’. Spending time with, and listening to, young people impacted positively on self-esteem and confidence. A willingness to just listen to young people enabled them to better deal with their feelings, become more reflective and to understand the consequences of their behaviour on both themselves and others. Young people found it difficult to articulate specific interventions or approaches that had worked and why but they reported ‘you have got to have rules’, ‘helped me change the way I behave’, ‘they [key workers] were doing things for my good’ and ‘[The IIP] made me realise I'd actually got it a bit wrong’.

The trust placed in key workers was crucial in enabling young people to address some of the underlying issues that had been present for a number of years. After building a relationship with his key worker, one young person felt confident in expressing his on-going guilt about his siblings being taken into care and the death of his father. Another young person was able to express his pent up feelings about his father leaving the family home. After undertaking a series of anger management sessions, team building exercises and other group activities, both these young people were better able to deal with their deeply entrenched emotional issues resulting in more stable behaviour and improved school attendance.

For some young people social isolation was problematic. Inclusion in a film project overcame some of these barriers. Three young people found the film project to be helpful and they became less socially isolated and more confident. One spoke positively and explained ‘it [film project] gives you summat to do instead of being bored’. Improved self-esteem and confidence were reported by all young people. Specific instances such as taking a lead role in the film project by one young person, and undertaking work experience programmes by two other young people, had a positive impact on their feelings about themselves. One young person described how they had become more confident and independent, less aggressive and able to manage money as a result of the IIP.

Some young people found themselves in risky situations and in danger of being drawn in to anti-social behaviour and criminal activity. In some cases, a suite of interventions building trust between the key worker, parents and the young person resulted in young people distancing themselves from risky situations and associating with a more positive peer group.

After experiencing problematic relationships with agencies, many young people were reluctant to engage with services of any nature. Key workers were able to encourage young people to consider referrals to other much needed services, such as sexual health, bereavement counselling and pregnancy services. A willingness to engage with services, accompanied in some cases by the key worker, helped young people to begin to address entrenched issues.

Practical support, such as being accompanied to school or medical appointments, being woken up every morning in time for school, and help with shopping and budgeting, was viewed positively and as a learning experience, which enabled young people to begin to take responsibility for themselves rather than becoming dependent on key workers. Two young people particularly appreciated the support provided in making choices about going to college: ‘helped me get a place in college . . . the IIP worker kept coming to me about filling in the application forms for college’.

Bespoke financial approaches and thinking flexibly about solutions were critical elements to this intervention. In some cases, problematic school behaviour, stemming from a lack of school uniform or not being able to afford bus fares, was easily addressed by providing these things. Improving home décor and fitting a new bedroom door were also considered to have helped one young person to stay calm and have his own space.

Crisis management was a crucial function of key workers, often ‘picking up the pieces’ in emergencies and deteriorating situations. Difficult circumstances had been addressed and prevented from escalating, such as further enforcement action, children being taken into care or homelessness (Batty and Flint, Reference Batty and Flint2012). The ability of key workers to be supportive and non-judgemental, while providing a bespoke suite of interventions, helped calm challenging situations and hold the family unit together; something valued by all family members.

A synthesis of all these interventions enabled young people to broaden their horizons. Key workers were able to act as a critical friend. One young person had developed a set of short- and long-term goals. He explained that, ‘I want to change all my life round, study more, become one of those quieter ones, quiet, mind your own business, do your own thing.’ He reported that previously he would have smoked cannabis and ‘just kicked off with people’, whereas now he was ‘staying after school for a bit and catching up’. He believed that he would be in a position to leave the project ‘when I'm more mature’, perhaps in his final year at college, ‘I've completed all my [IIP] sessions, now I need to make my own way.’

Another young person still wanted to pursue her education despite becoming pregnant: ‘I don't want to go to college and then have to miss time off from it while I have the baby so we're going to leave it a while so I can spend time with the baby and go to a school for pregnant teens and hopefully get my maths and English GCSEs.’

Many of the positive outcomes identified were ‘soft’ and could not be measured quantifiably but were nevertheless an important contributory factor in young people's learning. A number of young people achieved hard measurable outcomes such as improved school attendance and reduced criminal and anti-social behaviour. However, some young people's progress was interspersed with periods of crisis and instability. Nonetheless, young people still made considerable progress and achieved a greater sense of responsibility and self-confidence. A number of young people were working towards changing their behaviour, making independent positive decisions, seeing something to aim for and broadening their horizons. Soft outcomes were achieved forming the basis with which to build a more positive future trajectory.