PROG CHANGE - was 2D.4a What healthcare interventions exist to help children and young people who disclose bullying?

Problem

Bullying is a significant global public health concern affecting children and young people (CYP) in the community. There is evidence for long-lasting negative effects on social, psychological, and behavioural functioning into adulthood. However, guidance on how to help CYP who disclose a history of bullying is lacking. The aim of this research was to produce a qualitative synthesis of health-service based interventions to help CYP disclosing a history of bullying.

Approach

We conducted a systematic search of peer-reviewed publications in seven databases for studies targeting the availability and effectiveness of heath-service based interventions for bullying. Identified studies were screened for eligibility and duplication using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thematic analysis was then undertaken to summarise the types of interventions available targeting the prevention, identification, treatment of bullying for CYP.

Findings

Ten studies from seven countries were included in this meta-synthesis. CYP were aged between 6 to 25 years (x=17; sd=3.49). Four main themes were identified: Acceptance & Adherence; Targeting The Bullying Triad & Emotional Responses; Environment of Delivery; Feasibility of Follow-up. There were mixed approaches to gaining adherence to participation in interventions and encouraging accurate reporting of bullying effects to discourage misrepresentative accounts being made. These featured family, peers, and use of an app. The focus of intervention content was also varied between addressing the bullying triad (victimisation reduction, aggression reduction, and active bystanding) and/or the emotional responses to an act of bullying (controlling anxiety, depression, and boosting self-esteem). There were also variations in community based settings where CYP would feel comfortable attending sessions, and were most feasible for their lifestyle. Feasibility of follow-up was a point of debate in all of the studies, mainly due to accuracy of reporting and follow-up length.

Consequences

There is a lack of health-service based interventions for bullying. Current interventions use a mixed approach to reporting effectiveness, the most prevalent being clinical outcome and self-report or parental report. Clinically meaningful utilisation and impact of GPs in the delivery of these interventions appears to have little or no impact on their effectiveness. Especially as the studies in this review were delivered over multiple community settings, including: school-based, home-based, and primary healthcare clinics. Therefore, future development of bullying interventions could incorporate methods of delivery that involve other members of community healthcare teams as well involving GPs.