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The Hexagon: An Exploration Tool
The Hexagon can be used as a planning tool to guide selection and evaluate potential programs and practice for use.
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Core Components
Nurture group –Classic Boxall Model is a short-term, targeted, school based intervention designed to support children and young people with significant social, emotional, behavioural and mental health (SEBD/SEMH) difficulties. This intervention is delivered to groups of 6-12 students, in an accepting and nurturing environment, by two members of teaching staff who have been trained in the nurture interventions. This intervention is underpinned by 6 core principles; 1) The need for children’s learning to be understood developmentally; 2) Providing a classroom that is a safe base; 3) Importance of nurture to children’s well-being development; 4) Language as a key communication tool; 5) Recognising all behaviour as communication; 6) The significance of transition points in children’s lives. As a result of the programmes core focus, children develop positive relationships with their teachers, and also become better equipped to make friends, perform better in school, and confidently manage life situations.
Students included in this programme are carefully selected in their mainstream classrooms after their SEBD/SEMH needs have been assessed using the Boxall Profile. Following identification, they join nurture groups, but also remain part of their mainstream classes and partake in some mainstream class activities. In the nurture groups they take part in several activities including emotional literacy sessions, news sharing, relaxation, nurture breakfast, and other curriculum activities. Each child is set social and developmental targets. After the targets are met, then the child can be fully-reintegrated into their mainstream classes. Nurture group sessions are delivered 5 times a week, with each session lasting about 2.5 hours per day. The programme is typically completed in one to four terms. Teachers regularly contact parents to discuss their child’s place in nurture group; to seek feedback from parents; and provide ideas for home activities. The regular parental involvement promotes the success of nurture groups.
Nurture groups can be implemented in different settings including nursery, primary and secondary, and special needs schools. This intervention works best when a whole school nurturing approach is adopted. This is where all school staff understand the role of nurture groups, and where students progress from nurture groups and re-integrate into nurturing and supportive mainstream classes.
Fidelity
Programme fidelity is ensured by implementation of the following measures;
Practitioner training and consultation
Modifiable Components
Each child is set individual social and developmental targets. Nurture groups can be implemented across a range of educational settings.
Support for Organisation/Practice
Implementation Support
Nurture groups –Classic Boxall Model is delivered in the UK by Nurtureuk. They are a UK based charity committed to promoting mental health and wellbeing, and promoting nurture in education. Nurtureuk also provide other nurturing structures when nurture groups (Classic Boxall model) are not feasible, or when children’s need are subthreshold as assessed on the Boxall profile. These other structures include Nurture ABC, non-classic nurture groups, and after-school clubs.
Nurtureuk provide implementation support to practitioners and organisations to ensure the success of nurture groups from the onset. Nurtureuk provide a structured consultancy package designed specifically for schools, which includes school audit which allows the development of recommendations for schools and nurture groups. Nurtureuk encourage a whole school approach to nurture, so they work closely with school staff to develop the nurture ethos across the school. They also provide advice for running the nurture groups, which includes ensuring the nurture groups are composed of the right mix of students; and providing feedback on students with social, emotional, behavioural and mental health needs. Nurtureuk provide training and in-house support to nurture practitioners, and give practitioners advice to promote their professional development. Nurtureuk also offer strategies and resources to be implemented in nurture groups and classroom wide.
Licence Requirements
There are no licence requirements for programme delivery
Start-up Costs
Start-up cost to establish a nurture group is estimated to be less than £10,000. This includes training, consultation sessions, and other implementation costs. The actual cost is dependent on a number of factors including number of children in the group; if the group runs full-time or part time; if resources are used outside the nurture group hours; etc. Other implementation costs include an estimated £8,700 intervention cost per child, £395+VAT for schools accreditation/ re-accreditation and £718 training cost per new nurture practitioner. If a whole school nurturing approach is adopted, then this will cost an additional £1500 +VAT in the first year, and £1485 + VAT in the second year.
Building Staff Competency
Qualifications Required
A Nurture group (Classic Boxall Model) is typically run by two teaching staff, therefore relevant training and qualification is required. Teaching assistants can also deliver this programme. Nurture practitioners should have the appropriate range of personal attributes to run the nurture groups, such as being caring, compassionate, and fair.
Training Requirements
To deliver Nurture groups –Classic Boxall Model, practitioners are required to attend a three day course on “The Theory and Practice of Nurture Groups”. This training covers the practicalities of implementing nurture groups; attachment theory and neuroscience; child development and learning; and Boxall Profile. To successfully complete the certificated course, practitioners complete an assessment. This is needed to evaluate their understanding of practical use of the programme, and practitioners’ professional development as a result of attending the course.
Supervision Requirements
Practitioners receive consultation sessions to help them implement the programme. Consultation sessions cover recommendations for running nurture groups; support and advice for practitioners; strategies and resources to be implemented in nurture groups and classroom wide. After schools have run nurture groups for at least two years, schools can apply for the Marjorie Boxall Quality Mark Award (MBQMA). This is an accreditation scheme for excellence in nurturing, and it signifies that the schools deliver nurture groups according to good practice against a set of quality standards.
Theory of Change
Nurture groups- Classic Boxall Model is based on attachment theory, as the programme focuses on supporting students in forming attachments with caring adults in their school. These adults provide important attachments for the students, which can help overcome missed or distorted nurturing experiences in the child’s life. The unconditional positive regard the students have for these nurturing adults is believed to be a powerful mechanism for change.
Primary school: 6 to 12 years - Rating: 4+
Research Design & Number of Studies
The best evidence for nurture groups in children aged 6-12 years comes from two externally conducted quasi experimental studies (QEDs) that included children aged 5-7 years.
Outcomes Achieved
Compared to the control group, the following outcomes were observed
Child Outcomes
Significantly reduced conduct problems, emotional symptoms, peer problems and hyperactivity (Sloan et al, 2016; Sloan et al, 2020)
Significantly increased prosocial behaviours and school enjoyment (Sloan et al, 2016; Sloan et al, 2020)
Significantly improved self-esteem and academic attainment (Reynolds et al, 2009)
Parent Outcomes
None
Key References
Sloan, S., Winter, K., Connolly, P., Gildea, A. (2020). The effectiveness of Nurture Groups in improving outcomes for young children with social, emotional and behavioural difficulties in primary schools: An evaluation of Nurture Group provision in Northern Ireland. Children and Youth Services Review. 108, 104619, 1-11
Sloan, S., Winter, K., Lynn, F., Gildea, A. & Connolly, P. (2016) The impact and cost effectiveness of Nurture Groups in Primary Schools in Northern Ireland. Belfast: Centre for Effective Education, Queen's University Belfast
Reynolds, S., MacKay, T., & Kearney, M. (2009). Nurture groups: A large‐scale, controlled study of effects on development and academic attainment. British Journal of Special Education, 36(4), 204–212
Need
Comparable Population
Nurture group –Classic Boxall Model is a targeted school based intervention designed to support children and young people with significant social, emotional, behavioural and mental health (SEBD/SEMH) difficulties. Nurture groups can be delivered across several settings including nursery, primary, secondary, and special needs schools.
Is your organisation looking to deliver an intervention to address needs of children with SEBD/SEMH difficulties? Is this intervention to be delivered in nursery, primary, secondary, and special needs schools?
Desired Outcome
Programme delivery is associated with significant improvement across several outcomes including socio-emotional functioning, academic attainment, self-esteem, and child behaviour.
Are the above outcomes priorities for your organisation? Are there other outcomes that your organisation would like to achieve, which are outside the premise of nurture groups? Does your organisation have other systems in place that effectively and efficiency address the above outcomes?
Need Score
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Fit
Values
Nurture group –Classic Boxall Model is a short-term, targeted, school based intervention designed to support children and young people with significant social, emotional, behavioural and mental health (SEBD/SEMH) difficulties. Nurture groups can be delivered part-time or full-time, across several settings including nursery, primary, secondary, and special needs schools. Nurtureuk encourages a whole school approach to nurture, so they work closely with school staff to develop the nurture ethos across the school. Programme delivery is associated with significant improvement across several outcomes including socio-emotional functioning, academic attainment, self-esteem, and child behaviours.
Is your organisation looking to deliver an intervention for children and young people with significant SEBD/SEMH difficulties?
Priorities
Is providing a targeted, school based intervention for children and young people with SEBD/SEMH difficulties a priority for your organisation? In what school setting will this intervention be delivered, e.g. nursery, primary, secondary, or special needs school? Will your organisation apply a whole school approach to nurturing? Is delivering this intervention part-time or full time be a better fit for your organisation? Will your organisation target children with different types of behavioural and/or emotional difficulties, or will the focus be on specific problems, e.g. depression?
Existing Initiatives
Does your agency have existing programmes for children and young people with significant SEBD/SEMH difficulties? In what settings are the existing programmes delivered? Do existing initiatives employ a whole school approach? Are the existing initiatives effective? Do the existing initiatives fit your current and anticipated future requirements? Do the existing initiatives address similar outcomes as nurture groups? Are there components within the nurture group intervention that are not met by existing programmes?
Fit Score
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Capacity
Workforce
Each nurture group (classic boxall model) is typically run by two teaching staff, for example a teacher and teaching assistant. Qualifications and experience that qualifies practitioners to take up teaching/ teaching assistant role is required. Nurture practitioners should have the appropriate range of personal attributes to run the nurture groups, in that they should be caring, compassionate, and fair. Practitioners attend a three day training course prior to delivering the programme.
Does your organisation have practitioners with the required qualifications and experience, who are interested in learning and delivering this programme? Do they have time within their job plans to undertake the recommended training, and deliver the programme? Is your organisation committed to supporting the training of practitioners in this programme?
Administrative Support
Nurture groups are delivered in schools, and regular parental involvement promotes the success of the groups. Nurture group activities include news sharing, relaxation, nurture breakfast, etc. nurtureuk encourages a whole school approach to nurture, so they work closely with school staff to develop the nurture ethos across the school.
How will parental contact be initiated and maintained? Does your organisation have the facilities to conduct nurture group activities? Does your organisation have administrative capacity and systems for a whole school nurture approach?
Financial Support
Start-up cost to establish a nurture group is estimated to be less than £10,000, dependent on the number of children in groups; if groups run full-time or part time; if resources are used outside the nurture group hours; etc. Other implementation costs include an estimated £8,700 intervention cost per child, £395+VAT for schools accreditation/ re-accreditation and £718 training cost per new nurture practitioner. If a whole school nurturing approach is adopted, then this will cost an additional £1500 +VAT in the first year, and £1485 + VAT in the second year.
Will your organisation adopt a whole school nurturing approach? Can this be financially supported? Can your organisation afford the estimated cost of establishing nurture groups, and the cost of the intervention per child? Will your organisation adopt measures to reduce cost of establishing and implementing nurture groups, e.g. running the programme part-time? Will your school apply for the Marjorie Boxall Quality Mark Award (MBQMA)? Can your organisation afford the accreditation fees? Have you identified sources of funding for this intervention?
Capacity Score
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