Anxiety in children and young people: 

Experiencing anxiety and worry is normal and common in people of all ages. While we all experience anxiety sometimes, there are times when anxiety and worry can feel very difficult to manage and can have a big impact on really important aspects of our lives.  Anxiety can for example, make us feel very upset and get in the way of the things that we would like to do.     

Common types of anxiety in children and young people include: 

• Fears of specific things (e.g. dogs) of places (e.g. the dentist). 

• Fears of being separated from your family 

• Fear of the unknown or uncertainty 

• Fear of social situations 

• Panic:  Fear of disaster or being out of control 

• Worries about upcoming changes, such as changing school 

For children and young people experiencing these difficulties, learning a little more about anxiety and ways of overcoming it can be helpful.  

Low Intensity Anxiety Management: 

Low intensity anxiety management (LIAM) has been developed by NHS Education for Scotland (NES) and experts in the field of anxiety in children and young people.   

LIAM is designed to help children and young people learn more about anxiety and ways to overcome it.  It is based on cognitive behavioural therapy (CBT) principles and focuses on what happens to our thoughts, feelings and behaviour when we feel anxious.  Importantly, LIAM helps children and young people to learn new ways of dealing with anxiety.   

In your school, LIAM is offered to children and young people who are experiencing anxiety that they are finding upsetting or difficult to manage.  Children and young people will meet with a school staff member to work through LIAM resources together. It involves meeting with a member of staff on a one to one basis.  Often LIAM can take 6-8 appointments to complete.  

LIAM is run as a partnership between your school, NHS Grampian and Aberdeen City Council.   

Service evaluation, Audit and Research 

We are keen to evaluate how useful LIAM is for children and young people in the school environment.  This will help us plan and improve the delivery of LIAM in the future.  

In order to do this we will ask you to complete questionnaires during your appointments.   

The help you get from the LIAM staff will not be affected if you decide that at any time you do not want to take part in this evaluation. 

What we will do for you if you decide to take part: 

• Ask you to give your consent to let us use the information collected to evaluate LIAM.  This information will be completely anonymous (your name and other identifiable information will not be used).   

• We ask that you consent to this information being used for current and future research and evaluation.  

• This information will be combined with information collected in a number of schools across Scotland to help us with our evaluation. 

• This information will be used by NHS Grampian and NHS Education for Scotland (NES).  It will be stored securely and confidentially within these organisations. 

• We will make sure we keep information which relates to you safe and secure and you will not be identified in any reports that follow. 

Further information  

If you have any questions, please speak with your LIAM worker and they will be happy to discuss any of the above in more detail with you. 

Proposal 

Following on from the success of our LIAM pilot within the Cults ASG, The Fit Like Family Wellbeing Service are delighted to offer your school the opportunity to have LIAM delivered to a small group of up to 10 pupils within their school environment.   

This will run for a total of 9 weeks of around 1.5-2 hours during Term 3 (this includes an introduction/getting to know you session). 

Aims 

To support children and young people, using a CBT approach, to better understand anxiety and find helpful ways of coping with anxious thoughts and feelings.  Thinking about the 3-stage framework, this sits within early intervention (universal and targeted), with the hope that by receiving this support earlier we may prevent escalation of need towards tier-3 (specialist). 

We would like to be in the position where we can measure impact of LIAM delivery within a locality setting, as opposed to a citywide approach.  This would enable us to explore the benefits of locality delivery and, depending on data gathered, be able to evidence and influence wider delivery across the city.   

Why your schools 

We regularly audit our Request for Assistance process and note that there have been a number of RFAs from some of your schools where anxiety is cited as a primary concern and for others, where there are no LIAM workers within your school, this should be seen as a preventative supportive measure to increase capacity. We know that children and Young People benefit from anxiety being normalised and delivering this in a group format helps children and young people see that they are not alone and that they can support one another.  

Who? 

Whilst we believe LIAM would benefit all children and is a ‘no harm’ intervention, we are only in a position to run this during Term 2 and therefore would ask that you consider which children you think would most benefit from this intervention, i.e., a targeted group.  Considerations should include need, age range, and ability of pupils to attend and engage.  LIAM is an early intervention approach so it wouldn’t necessarily be appropriate for those children who are currently receiving or awaiting CAMHS input and not for those who are currently not managing to attend at all. 

LIAM tends to have most success for children who are showing some signs of anxiety-symptoms and who may have a tendency towards worrying more than might be expected of a child their age/stage.  We would envisage the group to be no more than 10 children.   

Facilitators 

Each group will be supported by two LIAM trained colleagues from Fit Like.  In schools where you have LIAM workers, we would ask they could shadow the group to allow the model to be embedded within your school.  

 Sustainability 

We are happy to discuss how we might support you setting up a regular group within your school using those currently trained in LIAM. We know that mental health is a huge issue affecting so many of our young people and the evidence tells us that this approach works as a response to symptoms of anxiety. It is important to us that we help you think about how you can carry this on within your school to prevent escalation to targeted/specialist. If we could, we would deliver LIAM groups across all primary schools at P5 level and all secondaries at S2 level. We hope that we can support you to look at a sustainable model. 

Location 

Because we are running these with pupils attached to one school, we are hopeful that those pupils put forward will find it easier to attend.  We would need a space big enough for a group of up to 10 children, with access to a projector. 

Resources 

We have developed a PowerPoint for each module of LIAM which can be delivered to groups.  There are also handouts for participants.  It would be great if you could provide each child with a ‘LIAM folder’ so that they can store their work. 

Expectations of children and families 

LIAM encourages home tasks and reflections outwith the session.  We also provide information to parents/carers so there is a basic expectation of their support. Families will be offered a session at the end so that they can ask any questions and be supported with strategies moving forward. 

Anything else? 

Firstly, does this sound like something you would like us to deliver within your school?   

If so, please get back in contact with us to discuss how this might look in your school.