The Optimus blog

The blog that inspires leaders in the UK education sector

The Optimus blog

The blog that inspires leaders in the UK education sector

Gareth D Morewood

How (and why) we set up a secondary nurture group

Supporting students in a nurturing environment was a formative step in our school’s progression towards a model for inclusion. Here is what we did.

Ten years ago, at Priestnall School, we established a nurture group to support students’ transition from our feeder primary schools to Year 7 (any beyond, when required).

Even though they were due to start in Year 7, some students have needed additional time to settle into the secondary school environment. Many, but not all of these students have had specifically identified SEND. We tailored the group to provide bespoke support for their individual needs as part of a bespoke, personalised approach.

We haven’t run the group for the last few years, after further development to our whole-school inclusion model. But creating a coordinated CPD offer and adjusting environmental factors (Morewood, in Bartram [Eds], 2018) to become the inclusive school we are today we wanted to take our time, and not rush anything, so having the nurture group was an essential part of our journey.

I am often asked how we set up our school’s nurture group and what it involved, so here I thought I would summarise the main ideas and discussions that led to its creation.

What is a nurture group?

Nurture groups are an in-school, teacher-led psychosocial intervention involving groups of fewer than 12 students, that effectively replace missing or distorted early nurturing experiences. The aim is to immerse students in a comfortable and accepting environment, thereby helping them to develop positive relationships with their teachers and peers.

The concept of a nurture group was originally devised by educational psychologist Marjorie Boxall, who also developed the Boxall Profile.

What made our group unique?

As part of the development of provision for students at Priestnall School, we established the nurture group in September 2008 to support vulnerable learners in a bespoke environment. The initial cohort was made up of 10 Year 7 students, and two Year 8 students with specific emotional and mental health needs.

As well as setting up the group, I also taught the students for the first term, establishing the routines, expectations and rationale of the group and ensuring the vision was clearly communicated across the whole school. In January 2009, we appointed a specialist teacher to take daily responsibility for the students attached to the group and their integration into mainstream lessons.

Why did we set it up?

The rationale behind our nurture group was the pro-active support model we had established and developed over the previous few years. Our aim was to focus on positive, constructive interventions, rather than the reactive measures historically taken in secondary schools.

Inspiration for our methodology came initially from the TEACCH training I had attended with Professor Gary Mesibov. Together we explored the different ways we can use positive strategies and carefully structured routines to support young people in a nurturing environment.

Our aim was to focus on positive, constructive interventions

However, it was the work of Dr Bruno Bettelheim, child development specialist and controversial professor at the University of Chicago who popularised the ‘refrigerator mothers’ fallacy in the 1950s and 1960s, that became an unlikely source of the basis for our methodology. Many articles and books published in that era attributed autism to the absence of maternal affection.

It’s clear to see how Bettelheim came to the conclusion that autism was developmental in relation to the mother, bearing in mind John Bowlby’s formative work in developing attachment theory. However, as part of creating the rationale for our nurture group, I knew I needed to look beyond these early misdiagnoses.

Bettelheim and (Emmy) Sylvester felt that, while one-on-one therapy was appropriate for adults, a therapeutic community – or therapeutic milieu – was more suitable for ‘troubled children’. Bettelheim in particular believed that there were significant beneficial group effects from this method, and encouraged almost unconditional gratification of the child’s basic needs, a secure protective setting and carefully measured doses of reality.

It is from the combination of specific TEACCH strategies and Bettelheim’s concept of the ‘therapeutic milieu’ that we decided to put bespoke participation and learning opportunities at the heart of our nurture group.

How does the group link to our whole-school approach?

Setting up the nurture group was relatively straightforward, but doing so in conjunction with existing whole-school systems and structures was another challenge altogether. In the first year, it was important that everyone at Priestnall understood how the nurture group operated, and how it matched the principles of other interventions and whole-school responses.

A nurture group must be fully embedded in your whole-school systems if it is to succeed, and work done with feeder primary schools in identification and assessment is integral to including the right cohort of young people in the group.

How did we set the group up?

As is often the case when developing provision, we made mistakes. The greatest was not having a mainstream timetable for the first cohort, so that when we integrated students into mainstream lessons we had to start from scratch. We later introduced timetables so that we could offer a more personalised approach to integration, as informed by the McSherry Readiness Reintegration Scale.

Investing in a more gradual integration into secondary school produced better GCSE outcomes and pathways to post-16 provision

Initially there were fears that students would miss out on lesson content by being part of the group. However, tracking over time showed that investing in a more gradual integration into secondary school produced better GCSE outcomes and pathways to post-16 provision, when compared to individual students’ starting points. We made a point of assessing potential students through practical observations, considering the following criteria as developed from the McSherry Re-Integration Programme.

Self management of behaviour

  • Can accept discipline without argument or sulking
  • Can settle down quietly and appropriately
  • Does not leave the room without permission
  • Shows self-discipline when others try to encourage distraction
  • Uses appropriate language
  • Uses language at an appropriate volume
  • Does not seek confrontation

Self and others

  • Can behave appropriately in the classroom
  • Can accept that teacher time needs to be shared
  • Can ask a question and wait for the answer
  • Can take turns in 'question and answer' situations
  • Communicates in an appropriate manner
  • Is able to work in a team
  • Can speak to people politely

Self awareness and confidence

  • Can ask for help
  • Can accept responsibility for actions
  • Can acknowledge own problems
  • Can risk failure
  • Has a positive outlook

Learning skills

  • Does not get up and wander around
  • Does not get impatient if help is not immediately forthcoming
  • Will try to start a task on their own
  • Generally cares about the work being done
  • Pays attention to class discussions and instructions
  • Is able to ask others for help when experiencing problems

Additionally we used data provided by primary school colleagues and families. Using a list of criteria, we triangulated responses from school, homes and through observations in taster sessions. It was important to get the right mix in the group for the therapeutic milieu to be effective.

Balancing the risks and needs of each student against the ability of the wider group was crucial; the more information we had, the better the group functioned.

Child-centred approach

While our nurture group was very specifically designed for our community and a precursor to our current model for inclusion, there still is a need for such provision today. This is true for schools that are only starting on their journey to inclusion, or in areas where young people with specific needs are not currently being met through quality first teaching and intricate systems.

You can find out more about other nurture group models and approaches from the Nurture Group Network, which includes links to research, evidence and publications.

Whatever you do, maintaining a child-centred approach is key and balancing that with current curriculum demands is always hard, but for some learners and essential part of personalisation and making reasonable adjustments for SEND.

More from Optimus

Transition for pupils with autism: what does research tell us?

Investing in interventions: what does the research tell us?

Further reading and references

Bartram, D. (2018) (Eds), Great Expectations: leading an effective SEND strategy in school, John Catt Publishing, Woodbridge.

Bettelheim, B., & Sylvester, E. (1949) ‘Milieu Therapy: Indications and Illustrations’, Psychoanalytic Review 36, 54-68.

Bishop, S., (2008), ‘Running a Nurture Group’, SAGE Publications.

McSherry, J., (1999), ‘A re-integration programme for pupils with emotional and behavioural difficulties’, SENJIT.

Morewood, G. (2009), ‘Making optimum use of SENCO time’, Curriculum Management Update, May, Issue 95, Optimus Education.

Morewood, G. (2008), ‘The 21st Century SENCO’, SENCo Update, November, Issue 100, Optimus Education.

Pollack, R. (1998), The Creation of Doctor B: A Biography of Bruno Bettelheim (Touchstone).

Zimmerman, D.P., & Cohler, B.J. (2001) ‘From Disciplinary Control of Benign Milieu in Children’s Residential Treatment’, Zimmerman, D.P., The Forsaken Child: Essays on Group Care and Individual Therapy, Haworth Press.


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