School-based screening for childhood anxiety problems and intervention delivery: a codesign approach

Victoria Williamson, Michael Larkin*, Tessa Reardon, Samantha Pearcey, Roberta Button, Iheoma Green, Claire Hill, Paul Stallard, Susan H Spence, Maria Breen, Ian Mcdonald, Obioha Ukoumunne, Tamsin Ford, Mara Violato, Falko Sniehotta, Jason Stainer, Alastair Gray, Paul Brown, Michelle Sancho, Fran MorganBec Jasper, Cathy Creswell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives: A very small proportion of children with anxiety problems receive evidence-based treatment. Barriers to access include difficulties with problem identification, concerns about stigma and a lack of clarity about how to access specialist services and their limited availability. A school-based programme that integrates screening to identify those children who are most likely to be experiencing anxiety problems with the offer of intervention has the potential to overcome many of these barriers. This article is a process-based account of how we used codesign to develop a primary school-based screening and intervention programme for child anxiety problems. Design: Codesign. Setting: UK primary schools. Participants: Data were collected from year 4 children (aged 8–9 years), parents, school staff and mental health practitioners. Results: We report how the developed programme was experienced and perceived by a range of users, including parents, children, school staff and mental health practitioners, as well as how the programme was adapted following user feedback. Conclusions: We reflect on the mitigation techniques we employed, the lessons learnt from the codesign process and give recommendations that may inform the development and implementation of future school-based screening and intervention programmes.
Original languageEnglish
Article numbere058089
JournalBMJ Open
Issue number6
Publication statusPublished - 21 Jun 2022

Bibliographical note

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:


  • Mental health
  • 1506
  • 1712
  • education & training (see Medical Education & Training)
  • mental health
  • paediatrics
  • Behavior Therapy
  • Parents/psychology
  • Humans
  • Anxiety/diagnosis
  • Child Behavior Disorders
  • Child
  • Schools


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