Case Study

In Northern Ireland there are 6 Health and Social Care Trusts providing health and social care services.   Our team is based in the Southern Health and Social Care Trust (SHSCT).

The SHSCT provides health and social care services across the five council areas of Armagh, Banbridge, Craigavon, Dungannon, and Newry and Mourne.

The Trust employs approximately 13,000 staff.  The Trust delivers services from several hospitals, community-based settings and directly in individuals’ homes. A comprehensive range of services is provided through the following Directorates:

• Acute Services
• Adult Mental Health and Disability Services
• Adult Community Services
• Children and Young People’s Services
• Nursing, Midwifery and Allied Health Professionals

The ‘Seasons of Life’ team comprises of 16 professionals mainly working in the Children and Young People’s Services Directorate (CYPS). The team also consists of 2 community organisation representatives, an Education Authority representative and we have 5 service users who are members of our steering group.

The ‘Seasons of Life’ team works in community settings, schools and in individual homes.

The HSC staff in the team are mainly Specialist Community and Public Health School Nurses and Paediatric Psychologists.  School nurses are registered nurses with additional training in public health, focusing on prevention and early intervention to address both physical and mental health needs.

Paediatric psychologists help children, and their families cope with the psychological aspects of health conditions, developmental issues, and emotional or behavioural challenges.

Prior to forming the Seasons of Life programme these 2 services have never collaborated before.

‘Seasons of Life’ is an innovative bereavement and loss support programme developed by healthcare staff in the SHSCT and delivered within the school setting.

The team introduced new thinking by recognising loss extends beyond bereavement to include parental separation, care experience, refugee status, or family imprisonment—meeting an unmet and growing need. Delivered by a multidisciplinary team, the programme combines clinical expertise with creative approaches such as narrative and art therapy. Workshops offer a safe space for young people to explore grief, build resilience, and connect with peers

Strong leadership has driven the initiative’s success, with a clear vision and strong communication.  Success has been celebrated throughout the programme and the focus on staff wellbeing has increased morale. The programme has been co-designed with young people, parents, and staff, and adapted to include neurodiverse and ethnically diverse children—ensuring equity and inclusion.

A strong foundation for sustainability includes a Standard Operating Procedure, staff training, and senior leadership support. With growing demand and no similar initiative elsewhere in Northern Ireland, ‘Seasons of Life’ is highly transferable and ready for regional rollout.

‘Seasons of Life’ deserves recognition for its leadership, creativity, compassion, and powerful impact on the lives of young people.

Staff within the SHSCT identified a growing number of young people on their caseloads who had reached crisis point following a bereavement or a significant loss.  Staff recognised that earlier, proactive support could reduce the severity of need and promote healthier long-term outcomes.

In response the team developed ‘Seasons of life’, an innovative school-based programme designed to support young people navigating grief and loss. Uniquely delivered by a multidisciplinary team of healthcare professionals, the programme provides early intervention within a familiar and accessible environment.

Seasons of Life’ supports young people experiencing a wide range of losses—including bereavement, parental separation, being in care, or having a family member in prison. The programme educates participants on the signs and symptoms of grief, the difference between normal and prolonged grief, and where to find help.

Through a combination of narrative and art therapy techniques, the programme offers a safe and supportive space for young people to share stories of strength, resilience, and loss—with both professionals and peers who understand.

Its goal is to empower young people to actively engage in their grief journey, build healthy coping strategies, and access timely support. Each session also includes the opportunity for 1:1 conversations and onward referral where needed, helping to prevent more complex emotional needs in the future.

Staff identified a need for bereavement and loss support workshops for school-aged children due to increasing numbers of families requiring support.

Drawing on past successful service-user projects, staff ensured public engagement from the beginning. A bereaved parent and her daughter were consulted at the project’s inception, informing the workshop design and joining our steering group.

A pilot workshop was delivered, with feedback gathered from staff and from young people who participated in the workshop.  Both felt the workshop could be improved and ideas were shared.  Suggestions led to improvements through PDSA cycles.

To deepen engagement young people, school staff and parents/carers joined our project steering group, contributing to co-design of the workshops.

A workshop information leaflet was co-designed with the young people and circulated for comments. A copy is provided in the Additional Evidence section.

A focus group was held with young people. We used the 1-2-4-All liberating structure technique to ensure all their opinions and feedback were heard, and their input led to further change.

Together, the team created a Project Charter outlining objectives, scope, stakeholders, and a project timeline for the team to follow.

Action plans, communication plans and data management supported effective project tracking and ensured clarity of roles.

The Seasons of Life workshops exceeded expectations, producing positive outcomes for young people, school staff and families. Unexpectedly, school staff shared their own grief experiences, allowing our team to support them. Additionally, family members and carers informed us they had sought support for their own grief after seeing positive changes in young attendees.

Impact was measured in various ways, and we collected both quantitative and qualitative data.

Our team designed pre – and post-workshop questionnaires which were completed anonymously by the young people.  The questionnaires used the Likert scale as well as open-ended questions, measuring coping, resilience, and knowledge of supports.  Results showed increased awareness of resilience skills, increased understanding of normal and prolonged grief, and increased knowledge about available supports. Please see a copy of the questionnaires and some charts showing data analysis in the additional evidence section.

All young people found the workshops helpful, 85% wanted to attend again and 15% reported they were considering attending a further workshop.

Semi-structured interviews revealed attendees had gone on to have more open communication about grief and they had accessed some services we had signposted them to following participation at a workshop.  See short video clips attached in supporting evidence section.

Data was also gathered via written comments or drawings on paper tablecloths during sessions.  This allowed anonymous sharing and no requirement to speak in front of the wider group.

In some schools, children who had previously disengaged with school life attended on the day solely to attend the workshop.  This was a welcome outcome for both health and education staff.

The team ensured inclusivity for neurodiverse, special educational needs, and ethnic minority children in both the workshop and data collection process.

Workshops raised awareness of the role of the school nurse and other health services, evidenced by 43 requests for 1:1 support with the school nurse after the delivery of 6 workshops. There were numerous onward referrals to mental health services, Cruse, and school counsellors.

The workshops empowered the young people to form peer support groups in schools.  The young people recognised that coming together with other people who felt similar to them reduced feelings of loneliness in grief.  They made new connections and friendships with other young people in the school whom they didn’t know prior to the workshops.

Our programme offers vital support to children experiencing bereavement and a wide range of significant losses, including parental separation, being a child in care, refugee status, or having a family member in prison.  Its flexible design allows it to be adapted for any type of loss, addressing an ongoing and universal need.

Within the SHSCT there are 55 post primary schools and 194 primary schools, representing approximately 70,000 school-aged-children.  Every school we have engaged with has reported a need for this type of support, and we currently have a growing list of schools requesting access to the programme.

To ensure sustainability, we plan to build capacity by training additional staff, equipping them with the skills and confidence needed to deliver the workshops.

As we continue delivering the programme we consistently share outcomes and feedback, helping to inspire and motivate others across the Trust to champion its expansion.

This is currently the only programme of its kind in Northern Ireland.  By sharing our model and demonstrating its success, we hope to see it implemented regionally in the future.

We also continue to collaborate with external partners, including the Northern Ireland Bereavement Network.  Our involvement in engagement events has contributed to the development of a Northern Ireland Children’s bereavement charter, helping to embed support within wider policy and practice frameworks.

The ‘Seasons of Life’ initiative stands out as this is the first programme of its kind in Northern Ireland to provide tailored, school-based workshops supporting children through bereavement and a wide range of losses- such as parental separation, being a ‘Child in Care’, having a family member in prison, or fleeing as a refugee.  It recognises that grief takes many forms, and every child’s experience matters.  What sets it apart is its inclusive, adaptable approach.  It recognises that loss extends beyond death and affects children in diverse and deeply personal ways.

The programme was co-designed with children, families and professionals ensuring it is not only clinically informed but also emotionally resonant and accessible.  We have embedded creative, child-friendly tools such as anonymous drawings on paper tablecloths, to capture young people’s honest thoughts. We have developed peer-led support structures, which foster trust and reduce the stigma around grief.

Another distinctive feature is its dual impact – supporting children and the adults around them. School staff and families have been empowered to better understand and respond to grief, creating a whole community approach to emotional wellbeing.

The initiative combines evidence-based practice with continuous improvement through PDSA cycles, service user feedback, and strong cross-sector collaboration.  It is scalable, sustainable, and already in high demand, with no comparable programme currently available in the region.

Its success lies not just in what it delivers, but in how it connects, empowers and transforms the experience of loss for young people – making them feel less alone and more understood.  ‘Seasons of life’ helps the young people find hope, comfort and a safe space during some of the most difficult times of their lives.

Key learning for our team was the value of working collaboratively across disciplines, rather than in silos. This approach enabled us to share knowledge, strengthen partnerships, and raise awareness of each other’s roles.

We found real benefit in applying quality improvement tools such as the Fishbone diagram and PDSA cycles, which supported structured reflection and continuous improvement.

Regular, clear communication was essential. SMART goals, action plans and inclusive meetings helped maintain momentum and fostered a shared sense of purpose among stakeholders.

Early and meaningful Service User Involvement was critical. Involving young people and families from the outset made the programme more relevant, sensitive, enjoyable and successful.

We recognised the importance of using both quantitative and qualitative data to measure impact and shape future improvements.

Raising awareness of the ‘Seasons of Life’ programme internally and through wider networks helped build strong engagement and support.

Staff wellbeing emerged as an important focus. Talking about grief can be triggering, so we developed tailored debrief sessions to support team members, particularly acknowledging disenfranchised grief in healthcare staff.

To ensure consistency and equity, we developed a Standard Operating Procedure, workshop presentation and workshop timetable.

Gathering and responding to feedback remains central to our learning and success.