Is it possible for pupil welfare teams to work health promoting and preventively? – A case study

ABSTRACT

Prior research about pupil welfare teams have identified problems at several levels: those of leadership, interprofessional cooperation, cooperation between the pupil welfare team and teachers, and type of work carried out. Perhaps most importantly, teams seem to work primarily with ‘firefighting’, i.e. acting reactively when problems already have occurred, rather than in a health promoting and preventive way. On the one hand, health promotion and prevention are endorsed as desired ways to work (e.g. SFS 2010, 800); on the other hand, reactive measures seem to dominate in practice. In order to try to bridge this gap, we carried out a study of a pupil welfare team in Sweden that we had reason to believe worked more in line with the health-promoting and preventive manner of working that is recommended. Since we could not know a priori whether the team studied worked in a qualitatively different way than other teams studied in prior research, we were led by two overarching research questions: (1) Is the studied team working in a heath promoting and preventive way? and (2) If so, how did their way of working emerge and how is it sustained? Our overriding purpose is to increase our knowledge concerning whether and how pupil welfare teams can become more health promoting and preventive in practice. More specifically, we are interested to find factors that contribute to the development and sustainability of health promoting and preventive work in pupil welfare teams.

KEYWORDS:

• Inclusive Education
• pupil welfare team
• health promotion
• preventive
• case study

Prior research

Pupil welfare teams are to be found in many countries. In the United States, for example, pupil welfare teams are often called prereferral (or intervention) teams and sometimes mainstream assistance teams. These teams are supposed to work with students having problems in school prior to the students’ being referred to special education. The teams are often supposed to play a central role in response-to-intervention approaches, making sure that as many problems as possible are solved in the regular education setting. Because much research has been carried out in the US with regard to these types of teams, the 10 most-cited articles in the Web of Science about prereferral/mainstream assistance teams in the US were analysed in order to get an overview of US research. One early influential study (Fuchs, Fuchs, and Bahr 1990) that reported on a research-driven intervention in which teams guided elementary school teachers in their work with pupils with behavioural difficulties provided some support for the intervention regardless of duration. Fuchs, Fuchs, and Bahr (1990) and Kovaleski et al. (1999) argue that a prestructured approach yields more favourable outcomes as long as it is adhered to (See also Telzrow, MacNamara, and Hollinger 2000. Noell and Witt [1999] analyse this issue in depth.). Burns and Symington (2002) conducted a meta-analysis that included nine studies of the outcome of the work of prereferral intervention teams. Effects were found for both university-driven teams and field-based teams. However, the effects of the former were substantially larger (See Welch, Brownell, and Sheridan [1999] for a more critical view of the research field.). In a similar vein, McDougal, Moody, and Martens (2000) strived to develop the acceptability of programme-driven prereferral intervention services. However, Fuchs et al. (1996) reported that it seemed difficult in practice for mainstream assistance teams to sustain successful university-led interventions, even when the district personnel experienced ownership of a successful intervention:

Results signalled that district personnel had achieved a measure of ownership of an effective practice and, more generally, that we had successfully bridged the notorious research-to-practice gap. Nevertheless, one year later, nobody in the district was using [mainstream assistance teams]. (244)

Thus, there seems to be evidence that prereferral-intervention/mainstream-assistance teams, when part of university-initiated programmes, have positive effects but that it is hard to bridge the research – practice gap in order to develop sustainable practices.

Finally, two of the ten influential papers set out to map, rather than to change, actual practices. Buck et al. (2003) point to the diversity of practices. Truscott et al. confirm this observation and point to a range of problems in current practices, such as loose regulations at the state level and a lack of consensus at the school level on goals. The most common recommendations by the teams involved testing and easy classroom interventions, while substantial instructional modifications were rare. In addition, problems were seldom approached from an ecological perspective. High-impact research tends to be from a while back, for natural reasons, especially in fields where there have been no obvious developments. However, in a recent article by Rosenfield et al. (2018), the main problem identified is still how to make the team work in a proper way in a natural school context (see also Nellis 2012). To sum up, research from the US shows some promise for preventive work with regard to special educational placements when teams are supported by external interventions (see also Young and Gaughan 2010). However, these interventions seem to be difficult to transfer to practice, where health-promoting and preventive work seem to be rare.

The findings concerning the work of teams in the US are similar to findings from other educational systems (see review by Thornberg 2008). Thus, to work in a health-promoting and preventive way seems to be an almost insurmountable challenge. Several additional problems with school-health-team work have been identified (Thornberg 2008): (a) a lack of goals and models, (b) too infrequent evaluations, (c) deficiencies in interprofessional cooperation, (d) lack of thorough investigation of problems, (e) the localisation of problems to pupils and their parents rather than to the school, and (f) obstacles for teachers to receive help and an excess of administrative work.

Since the case-study reported in this paper is carried out in Sweden, it is important to scrutinise prior research about pupil welfare teams in the Swedish context. In Sweden there is also a lack of health-enhancing and preventive work (Hjörne 2004; Guvå 2013; Guvå and Hylander 2017; Hylander 2011), yet there is a rhetorical acknowledgement of the necessity of working in a health-enhancing and preventive way. However, a lack of models and evaluations have been pointed out in the Swedish context as well (e.g. Hjörne and Säljö 2013). Further, Hjörne (2004) and Guvå (2009) found that Swedish teams seem to work mainly at the individual level, often trying to establish diagnoses, even though the teams sometimes criticise the work of principals, teachers, and the whole school. Interventions aimed at teaching strategies, for example, appear to be rare (Hjörne and Säljö 2013), and the teams seem to speak more about than with the teachers (Hylander 2011). The teachers, on the other hand, express that receiving help is a complicated process (Höög 2011).

Cases are handled in a formal structure in the Swedish system (Guvå 2013). Teachers initiate cases by expressing worries about students, and the principal has a gate-keeping function when it comes to involving the pupil welfare team (Einarsson 2011). The teams are not involved in the majority of student action programmes, according to the study by Guvå (2013). On the other hand, Swedish teachers seem to consider that the pupil is the responsibility of the pupil welfare team once the team becomes involved (Einarsson 2011; Guvå 2013).

To conclude, there seems to be a lack of health-promoting and preventive work in pupil welfare teams, both globally and in Sweden. In addition, several other problems concerning the work of pupil welfare teams have been identified. While there are some studies that indicate the possibility of moving the work of pupil welfare teams in the direction of working in a more preventive way, there is an obvious lack of studies on how sustainable change is achieved. We thus found it to be of interest to make an in-depth analysis of a case that seemed to be a good example in this regard. Before turning to the case-study of Castle School, we will describe our theoretical points of departure.

Theoretical points of departure

We build upon a pragmatic understanding of educational research and its relation to educational practice (Dewey 1916/1980; Biesta and Burbules 2003). Knowledge in educational science should thus be related to the development of schools and society and, ultimately, to democracy and to the development of more inclusive schools (see Nilholm [2006, 2020] for an elaborated discussion related to the special needs area). We believe that the functioning of pupil welfare teams that work with health promotion and prevention are of tremendous importance for such developments in that pupil welfare teams help students succeed in schools and thus help to provide them with the necessary knowledge, skills and virtues for participation in a democratic society.

Following our pragmatic line of reasoning, we believe that a theory about school health work has to prove its case in practice (Biesta and Burbules 2003). Lewin’s (1951) idea that there is nothing as practical as a good theory takes on a special meaning in the present situation. Rather than testing our own theories about how pupil welfare teams should work – for example, by doing interactive or participatory research or some kind of intervention – we believe that theory can be created by learning from those who seem to have solved the problem at hand.

Research questions

The empirical material was analysed through the following research questions:

• Is the pupil welfare team at Castle School working in a health-promotive and preventive way?

• If so, how has the present way of working developed, and how is it sustained?

The first question is to be seen as a prerequisite for the second one since it is asked in order to establish whether the Castle school could be regarded as a ‘best practice’ in the sense described above. The second research question is exploratory in its search for factors that can explain the development and sustainability of the practice.

The case study

The framework of the present investigation is a case-study approach, which is appropriate when a complex phenomenon such as the work of a pupil welfare team is studied (Stark and Torrance 2007; Yin 2002). The case study methodology makes it possible to (a) combine different analytical levels (b) preserve the integrity (wholeness) of the phenomena studied (c) is particularly suited for development of theory and (d) take complexity into account (Flyvberg 2006; Yin 2002; Rule and Vaughn Mitchell 2015).

A pilot study involving participant observation was conducted two years prior to the present study because the pupil welfare team in the school had an acknowledged reputation for working in a new way. In addition, one of the researchers had worked in a position which demanded knowledge about the work of pupil welfare teams in Sweden and had some prior knowledge about the work of the team at this school which indicated that the team worked in novel way. Thus, the pupil welfare team was a potential candidate for an in-depth case-study. The rationale of the pilot was to further explore if the school challenged traditions of pupil health care work. Thus, one of the researchers spent several weeks in the school in order to get acquainted with the staff, the pupils, and the work of the pupil welfare team. The pilot study confirmed that the pupil welfare team seemed to work in new ways, involving more health-promotive and preventive work than usual. Thus, the case was chosen for an in-depth study, and data was collected in the fall of 2017. As data collection began, the principal in charge of the pupil welfare team became seriously ill, and no one knew at the time whether he would return to the school. However, we decided to go on with the study, as our focus was on the work of the pupil welfare team, which had been built up over several years. The principal actually became healthy again and returned to the school late in the spring of 2018.

We will first present the setting of the case study. Then we will continue to describe the methodology used in the study in order to provide answers to the research questions above.

Castle school

The school studied is situated in a municipality of approximately 25,000 inhabitants. The school recruits pupils with mixed socioeconomic backgrounds. It encompasses kindergarten through ninth grade. At the time of the study, Castle School had 600 pupils, of which 117 had made an active choice to study there. When the pilot study was conducted in 2015, the school had only 450 pupils. Thus, the number of pupils had increased by 150 in the two years leading up to the study in 2017. The possibility for people to make an active school choice (rather than school placement being determined solely according to the proximity principle) and the high flow of refugees to Sweden in 2015 were the primary reasons for the increase. All of the 63 teachers working in the school at the time of the study were certified teachers, which is well above the national average. Seven of the teachers had worked at the school for more than 20 years, and an additional 17 had worked there for more than ten years. The principals taught at the school before they began working as principals in 2004.

The school had an outstanding record with regard to the number of pupils in grade 9 who became eligible for upper secondary school (Swedish National Agency of Education [SNAE] 2019). At the time of the study, 82.5% of Swedish ninth graders were eligible for upper secondary school, whereas, between 2010 and 2017, almost all ninth graders from Castle School were eligible for upper secondary school, with only a few exceptions. A few pupils had been retained during those years but subsequently became eligible. Results from national testing displayed a similar pattern, but in some years some girls did not pass the national testing requirements in math. However, the school provided extra measures for those pupils, and they finally received a grade in math that made them eligible for upper secondary school. This should be compared to the study by Persson (2013), who conducted a case study of an inclusive Swedish school (grades 7–9) in which all pupils became eligible for upper secondary during the year of the study and where the general level of results were higher than in the Castle School. On the other hand, that study focused on a change in results, whereas Castle School had been displaying good results for many years when it comes to eligibility while the schooĺs results per se does not stand out. Thus, the school had succeeded with what seem to be very hard in the Swedish comprehensive school where usually 15% of the pupils do not become eligible for upper secondary education. It should also be noted that the results of the school studied by Persson declined to close to the national average in the years following the study (Swedish National Agency of Education [SNAE] 2019).

The pupil welfare team at Castle School involved 13 persons. Pupil welfare teams in Sweden are mandatory for schools at the comprehensive level. The Swedish school law (SFS 2010, 800) states the basic principles with regard to the pupil welfare team: a) The principal is responsible for the team as well as its leader. b) The work should primarily be health promoting and preventive (however, se section on earlier research) c) The team should be multidisciplinary involving medical, psychological, social and special educational staff. Pupil welfare teams are supposed to work with learning, health and psychosocial issues.

Data collection

In order to address the research questions above, one of the researchers (Author 1) gathered comprehensive data material consisting of

• 13 ordinary pupil welfare team meetings with teachers (audio-recorded, researcher present but not participating);

• 3 reflection meetings of the pupil welfare team without the teachers and the principal (audio-recorded, researcher present but not participating);

• 1 focus-group interview with the pupil welfare team after 12 of the abovementioned 16 meetings (neither of the two psychologists could participate, so one of them was interviewed separately);

• 1 interview with the two principals. The principal who was ill participated by phone with speaker;

• a questionnaire with statements answered by likert-scales given to the 63 teachers (answered by 45 of the teachers (73%));

• a focus group with 6 pupils with special needs, 3 boys and 3 girls randomly chosen from all pupils with statements in one of the grades; and

• an interview with one of the school psychologists (because they were not able to be in the focus group with the pupil welfare team).

All participants were informed about the purpose of the study and their right to withdraw from the study at any point in time. Written consent was obtained from all participants except for the teachers. Written consent was also obtained from the parents of the pupils.

The interviews and focus-groups were semi-structured, with a list of pre-prepared questions derived from the overall research questions. A list of all a) questions asked in the interviews and the focus-group b) statements in the questionnaire and c) questions informing the observations can be obtained from the authors. Examples of questions/statements are provided below.

In addition, the principal responsible for the pupil welfare team and one of the members of the team participated in a member check (Creswell 2000), that is, they read a draft of the full manuscript of this paper and provided their perspectives on the accuracy of the descriptions and interpretations made in the paper in order to validate or challenge them. They both confirmed our understanding of events and they added additional information concerning a revealing event that occurred in 2018, after the study was concluded, where the number of pupils eligible for upper secondary education dropped substantially for that year specifically. This additional information was added to the final draft of the paper.

Data analysis

The empirical material was very extensive, and for the present paper, separate analyses that took each of the two research questions in turn as their points of departure were conducted. All the empirical material that had a bearing on each question was gathered. A similar procedure of data analysis was followed for both questions. For reasons of space, we will only provide a detailed description of the data-analysis with regard to the first research question.

The first research question concerned whether the team had worked with health promotion and with preventive measures rather than with reactive measures. Several questions in the different data materials addressed this issue more or less directly:

• How would you describe the pupil welfare team’s work in relation to the concepts health promotion, preventive and rectifying? (Interview with principals)

• In what ways do you work preventively? Describe. (Focus group with the pupil welfare team)

• In what ways do you work to promote health? Describe. (Focus group with the pupil welfare team)

• How do you work in a rectifying manner? Describe. (Focus group with the pupil welfare team)

• Do you know what the pupil welfare team is, who works there, and what they do? Do you have experience of being in contact with them? (Focus group with students)

• What can be detected with regard to the proactive, the health-promotive and the rectifying aspects of their work? (Observational focus while analysing the pupil welfare team meetings)

• In the questionnaire likert-scales were used. Several statements in the questionnaire dealt with the work of the team as in these two examples:

• In our school we work preventively in order to decrease different types of problems.

• The pupil welfare team primarily works with reactive measures.

Important information concerning the work of the pupil welfare team also appeared in other parts of the material, and that information was also used for further analysis.

The validity of the descriptions of health promotion, preventive and reactive measures was evaluated, and the balance between the use of these measures was appraised for each of the data materials. In this way, we gained access to several perspectives as regards the way the work of the pupil welfare team was being enacted. To put it somewhat differently, data from different sources were triangulated in order to validate descriptions of the work of the team. The next step in the analysis was to combine the different descriptions into a narrative. Narrative is a basic category of human understanding, as pointed out by Bruner (1991), which makes it a suitable form for integrating and communicating information. In this context, the way the narrative is constructed has to be as explicit as possible in order for the reader to evaluate whether it is convincing.

In a similar vein, the empirical material which concerned the second research question, i.e. how the way of working had developed and how it was sustained, was gathered and triangulated. Both the description of the way the team worked and the way the work had developed and been sustained was further a part of the validation done in the member check.

Results

Research question 1: Is the pupil welfare team at Castle School working in a health-promotive and preventive way?

According to the pupil welfare team, the teachers, and the principals, the pupil welfare team at Castle School had established a routine that is deemed very important for working in a preventive way. The teachers had access to the team without having to formulate specific problems with regard to classes or pupils. In this way, the participants all said, reactive measuers were avoided. During all observations of the team, only two instances of firefighting occurred: in one case it concerned pupils who felt offended by another pupil, and the other case involved concern for a pupil’s well-being. Further, in the focus group interview the team stated that they hardly ever work with firefighting. Ninety-three per cent of the teachers agreed fully or partly with the statement that the team is involved early on when problematic issues emerge. Ninety-eight per cent of the teachers knew how to get in contact with the team, and ninety-seven per cent considered it easy or fairly easy to get in contact with the team. Eighty-nine per cent of the teachers felt that they received the support they needed to do their work in a satisfactory way.

Furthermore, when similar problems occurred on a regular basis, those problems became the target for preventive work. This was affirmed by the principal and the pupil welfare team, and the researcher observed this in observations of the team’s work. One example of this was the recurring problem of speech anxiety, especially in situations where student work was to be presented in front of the classroom, as reported by the social worker, the nurse, and a special educator during a reflective team meeting. Discussions about this recurring problem were forwarded to the management team, which helped teachers develop preventive strategies to avoid the occurrence of speech anxiety.

An additional example of a health-promoting and preventive routine was that the pupil welfare team met all pupils for talks in small groups at the very beginning of lower secondary school (grade 7). They listened to how the pupils experienced their new school situation. One health-promoting measure that resulted from wishes expressed by the pupils during such talks was that more space was made for play in the schedule. In a more general way, the team expressed that they had adopted a salutogenic view of pupils’ problems – that is, they were more inclined to identify success factors and to build on the strengths rather than the shortcomings of the pupils. One of the members of the team, the youth recreational leader, had taken a particular interest in this perspective and had instructed the teachers on how to work in a salutogenic way. As shown in the observations and in the focus group interview with the team, pupils were rarely ascribed problems; rather, the issue at stake was how teachers could change their strategies. In the focus group interview the team members stated that the safety, well-being, and learning of the pupils was their primary focus. They stated that finding the strengths of the pupils would lead to increased motivation, well-being, and better grades.

The pupil welfare team also strived to be visible in the school environment. Observations and focus group interviews with the team and the pupils confirmed that the team was visible. The youth recreation leader was identified by the principal, by the team, and by the pupils in the focus group as a key person in the team’s achieving this objective to be visible. This also gave the youth recreation leader a central role in the pupil welfare team, as it was considered important to bridge the classroom with other contexts. Team members talked to the pupils and/or played games with them in order to strengthen relations with and trust among the pupils. This is an additional example of health-promoting and preventive work. All the pupils in the focus group interview stated that they felt safe and thrived at Castle School.

To sum up, there are several examples of health-promoting and preventive work in the material and an almost consensual view from the different participants that the team work in a health promotive and preventive way. Thus a picture of the work of the pupil welfare team emerged that is different from that which is familiar in the literature (see discussion section). Moreover, the team itself and both principals testified to the positive impact of this way of working on the results of the school.

Research question # 2: How has the present way of working developed, and how is it sustained?

One of the principals is pointed to as the main agent in establishing the work of the pupil welfare team in all the data material except one piece: for natural reasons, the focus group involving pupils did not have knowledge of this. For example, ninety-one per cent of the teachers agreed with the statement ‘The principal has decided how the pupil welfare team shall work at our school’, while fifty-four per cent agreed with the statement ‘The pupil welfare team has decided how the pupil welfare team shall work at our school’. However, it should be noted that the principal was the chairman of the team for several years, and the way the team worked was formed by his ideas. In the focus group interview, the members of the pupil welfare team repeatedly pointed out the percipient, not prestige minded, and distinct leadership of the principal, stating that this leadership was a very important factor behind the development and sustainability of the health-promoting and preventive work. In their joint interview the two principals stated that they had a mutual vision to change the work of the pupil welfare team in order to make the team into a medium of school change. Several of the people on the pupil welfare team could provide many examples of how the change was initiated. Further, the pupil welfare team members underscored that the vision was spread to the team and the teachers at the school. An additional factor important to the sustainability of the change was pointed out by the principals: that they and members of the team spoke, in recruitment interviews, about the vision and the team’s way of working. Newly recruited teachers were thus expected to uphold the vision and the team’s way of working.

The new way of working involved establishing routines and ways of working. One important aspect of this was to make the team easily accessible to the teachers. The rationale behind this, expressed in the focus group interview and in the interviews with the principals and also visible in the observational data, was to be pro-active and thus to avoid the use of reactive measures. One important strategy was to literally open up the door to the meetings of the school welfare team. Initially, no teachers responded to the new opportunity. Therefore, the principal created a new routine that required teachers to attend meetings of the pupil welfare team twice a year, when the teachers were about to grade the pupils. According to the principals and the team, this new routine seemed to lead to the teachers’ realising that they could receive support from the team in situations of less urgency. However, team members pointed out in the focus group interview that it took five years before the teachers stated in their annual evaluations that the work of the team was beneficial to them. Team members suggested that over the years it became easy to contact the team, and this was also confirmed by the teachers. The pupil welfare team further stated that a clear model of working had been established that was important to maintain and that should not depend on specific individuals. At the time of the study, the team was worried, though, whether they would be able to sustain the work given the fact that the principal had become ill. Further, the principals as well as the pupil welfare team point out the importance of continuity for developing a more health-promoting and preventive way of working. The principals and several of the teachers had accordingly worked at the school for a long time.

The team suggested that their once-a-month reflection meetings that did not include the principal or the teachers were important for working toward health promotion and prevention. They pointed to the egalitarian aspect of these meetings, stating that there they learned from each others’s knowledge and skills, established common viewpoints, and coordinated their different roles. The reflection meetings provided opportunities to transform reactive measures into preventive ones, as in the example concerning speech anxiety.

The team had also overcome a challenging problem in the Swedish school context concerning strict rules about professional confidentiality – which can often impede interprofessional communication in pupil welfare teams – by routinely asking parents (and pupils, when appropriate) whether team members could share confidential information within the team. This practice was regarded as very beneficial for cooperation within the team.

One important factor raised in the focus group interview with the team and witnessed during observation of team meetings was the importance given to the team’s perception that the teachers of the school were competent, knowledgeable, and experienced. Thus, according to the team, supervision of teachers often involved clarifying for the teachers that they themselves could provide solutions to their problems.

However, a very unfortunate but revealing event occurred at the start of the study in 2017, when the principal responsible for the work of the pupil welfare team became severely ill and there was a great risk that he would not be able to return to the school at all. The year after the principal became ill, the number of pupils eligible for upper secondary education fell below the national average. We received two different explanations for this in connection with the member check mentioned previously. The principal suggested two main reasons for the lowered results: first, in addition to his own illness, two important people responsible for the content areas of English and, perhaps more importantly, math also left the school; second, and what may be the key factor, some of the functions performed by the principal were not taken over by any team member. In particular, the principal had the executive function of making and carrying out key decisions after listening to the team. In this work his knowledge of the school organisation, of the pupils, and of the school’s context was extremely important. Thus, he was able to act preventively before the pupils failed. While the principal stated in the follow-up interview that the team continued during his illness to work in the way outlined, this important element seemed to be lacking. It seems that a sudden change to established arrangements could have quite far-reaching consequences.

After the principal returned to the school and took over the leadership of the pupil welfare team, the number of pupils eligible for upper secondary education returned to its prior level. The other team member who was involved in the member check suggested a slightly different but compatible explanation – that the workload of the other principal, who took over the leadership of the team in addition to several other tasks, meant this person had too little time to make and execute certain decisions. Further, the change in results could of course be influenced by the fact that different groups of children were involved at the different occasions.

Discussion

In the remaining part of this paper, we will discuss the outcome of the study in relation to earlier research and our theoretical points of departure as well as the study’s implications for practice.

The study in relation to earlier research

Several of the problems identified in prior research about pupil welfare teams (see e.g. Nellis 2012; Rosenfield et al. 2018) seem to have been less pronounced in the present studie. Most importantly, especially when led by the principal, the team studied seemed to have developed to a higher degree a way of working with health-promoting and preventive measures. In addition, other problems identified, such as the lack of clear working models, insufficient leadership, lack of interprofessional cooperation, and distrust from teachers, seemed to have been more or less absent. In this way, the pupil welfare team’s work resembles to some extent that of the teams involved in university-driven developmental work with a firm structure (cf. Kovaleski et al. 1999). However, as noted by Fuchs et al. (1996), university-driven interventions seem to be difficult to sustain. The main contribution of the present study in relation to earlier research is in its identifying factors in the work of schools that lie behind the realisation of sustainable change towards an increase in health-promoting and proactive work in pupil welfare teams. Several such factors were identified in the study:

1. the mutual vision shared by the school leaders at the outset

2. the need for a long time-span to develop new processes

3. the leadership itself (described as percipient, not prestigious and distinct)

4. the susceptibility of the school environment for change (cf. Ludvigsson 2009, about the co-production of leadership)

5. the increased availability of the team for the teachers

6. the regular meetings with newcomers in the 7th grade

7. the turning of specific problems into general issues (such was the case with the problem of speech anxiety)

8. the importance given to the work of the pupil welfare team when hiring new teachers

9. the ways to avoid problems involved with issues of confidentiality

10. the reflection meetings.

11. the visibility of the team in the environment and the building of relations with the pupils

12. the idea the work should be guided by a salutogenic perspective.

13. The view of teachers as competent, knowledgeable and experienced.

Thus, given that prior research mostly has identified shortcomings in the work of pupil welfare teams, we believe that this study provides an important research contribution in identifying factors that seem to contribute to how such teams can work in a more health-promoting and preventive way. Moreover, the identified factors are contextualised in a systematic and detailed description of the work of the team and how it has emerged. We believe that additional studies on pupil welfare teams that seem to be able to work in health promotive and proactive ways can cast additional light on the importance of these factors and the context-dependence on the findings of the present study (cf. Nilholm 2020). However, it is also important to note that when the principal became ill, the structures to uphold the full work of the team did not seem to be in place. To put it metaphorically, the web had lost its spider. Such dependence on specific leadership, of course, makes for vulnerability.

It should also be noted that the school studied had a high level of achievement, as indicated by the number of pupils eligible for higher education but less so by the results on national tests and as regards the general level of results. Even if one should be careful in interpreting such data, given that the school itself is responsible for the grading and for the administration, if not the content, of the national tests, it seems reasonable to contemplate the relation between the work of the pupil welfare team and what appears to be a high level of achievement specifically in relation to pupiĺs at-risk for school failure. The principal’s vision of the school as one in which all the pupils should be eligible for upper secondary education, and of the pupil welfare team as an important tool to accomplish this, was a vision that, as we saw, was spread to the whole school. While it is difficult to disentangle the team’s exact role in this endeavour, it seems that the strategy of working with health promotion and prevention is in line with what is considered good practice in special needs education. When led by the principal, the team seemed to have the ability to redefine problems, to see them not purely as characteristics of individual children, which was often a view taken by teachers, but as an outcome of interactions in the classroom that could be altered. This brings to mind the change of perspective described by Persson (2013). Persson (2013) also identifies leadership and change in routines as important change factors, but little is said in her study about the role of the pupil welfare team.

The study in relation to our theoretical points of departure

Given our pragmatic points of departure, we suggested that knowledge about schooling should be related to how schools can be developed in order to create a more democratic and inclusive society. Moreover, by studying exemplary practices, we can develop better theories of how this should be accomplished. We believe that the practice we studied, when led by the principal, indeed may have contributed to a more inclusive society by fostering pupils’ well-being and their eligibility for upper secondary education. This means the pupils have (a) the knowledge considered important by the Swedish school system for being a part of society and (b) better possibilities to gain access to the labour market and higher education. Thus, the theories enacted at Castle School seem to be functional in terms of achieving at least some of the aims of a democratic society. We have thus tried to develop theory by identifying what works in practice, i.e. in identifying the factors that contributed to the pupil health team being able to work in novel ways (cf. Lewin 1951). Such theories have the potential to be fruitful in the future development of educational practices (Dewey, e.g. 1916/1980; see also Lagemann 1989). Several of the factors identified in the present study identified as being beneficial in developing the work of the pupil welfare teams might be tried out and developed in new contexts in a continuing interaction between theory and practice (cf. Nilholm 2020).

It is important to point out, however, that the focus on goal achievement and health at Castle School mirrors, to a large extent, individualistic notions of the role that school is to play in society, while more collective aspects such as the creation of communities in schools and classrooms receives less attention (cf. Nilholm and Alm 2010), even if it is not absent in the empirical material.

Implications for practice

One benefit of working with data from a practice that seems to be working in a beneficial way is that the implications for other practices are comparatively clear. Thus, several, if not all, of the factors identified above might be tried out in new practices. However, given the contextualized nature of phenomenon such as the work of pupil welfare teams we believe that these factors have to be recontextualised in, rather than simply transferred to, new settings. What works in one context might not work in another context or have to be configured in slightly new ways. As the case study has illustrated it is by actors inventing and trying out new ways of working that pupil welfare teams, and schools in general for that matter, can develop.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by The Swedish Research Council.

Notes on contributors

Bibbi Larsliden

Bibbi Larsliden is a teacher at Örebro University, Sweden, and a special educator. Her main research interest is the work of pupil welfare teams.

Claes Nilholm

Claes Nilholm is a professor of education at Uppsala University, Sweden. His main research interest is inclusive education.