Optimising the delivery of mental health support to adolescents living in care out of home care via low intensity Life Story Work [LIMITLESS II]
| ISRCTN | ISRCTN18046151 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN18046151 |
| Sponsor | University of East Anglia |
| Funder | National Institute for Health and Care Research |
- Submission date
- 19/04/2024
- Registration date
- 10/05/2024
- Last edited
- 17/06/2026
- Recruitment status
- Recruiting
- Overall study status
- Ongoing
- Condition category
- Other
Plain English summary of protocol
Background and study aims
Teens are the fastest growing age group entering care, and the group most at risk of poor mental health. Better evidence on the ways carers can support teen's mental health is urgently needed.
Life story work is a way of promoting mental health for those living in care by helping them to understand who they are and how their experiences might have shaped them. This builds a sense of identity and belonging. It is usually delivered in a high-intensity way meaning it relies on specialist input over many months. It is therefore too expensive to provide to everyone. Life story work tends to be delivered solely to younger looked-after children (0-11 years old), and there is limited evidence and guidance available for its use with teens (12-18 years old). Ultimately, the most in need often miss out. Understanding if life story work could be delivered in a lower-intensity way (e.g., by foster carers) to teens, how and if this helps is vital.
Our recent project, LIMITLESS 1, reviewed international literature to understand when and how low-intensity life story work could work for teens. We produced initial guidance. For example, a teen should be supported by a carer to record everyday successes to promote self-belief. However, the literature did not tell us enough about how different external and/or internal factors may change how this should be delivered in different settings or if it makes a difference. To develop detailed advice that takes these factors into account and can improve mental health, we must now hear from those living and working in care. We will then need to test out if this advice is liked by teens, carers and social care professionals, if it is practical and learn how we could test if it helps.
We aim to improve the mental health of teens living in social care by improving the guidance available to support them.
Who can participate?
Carers, teens and Social Workers in partner local authorities.
What does the study involve?
This study has 5 stages. In stage 1, we will gain permissions to do our research and recruit and train 8 teens in care as co-researchers to help collect views from teen participants. In stage 2, we will ask participants to look at our initial guidance for teen-focused low-intensity life story work from LIMITLESS 1 and tell us how it could work (or not), when (and when not), why (and why not) in real life. In stage 3, we will use these findings to co-design detailed advice in the form of a “LIMITLESS Toolkit” to improve life story work delivery to teens. In stage 4, we will give 10 carers the toolkit to try, and update it using their feedback. Finally, to see if it is practical and learn how we would see if it helps, we will ask a larger group of carers to help, giving half the toolkit and asking the other half to carry on as normal.
What are the possible benefits and risk of participating?
Participants may enjoy helping a study that aims to improve guidance.
There are no direct risks from participating.
Where is the study run from?
School of Education and Lifelong Learning, University of East Anglia (UEA) (UK)
When is the study starting and how long is it expected to run for?
May 2024 to October 2027
Who is funding the study?
The study is funded by The National Institute for Health and Social Care Research (NIHR) (UK)
Who is the main contact?
Dr Simon P Hammond, University of East Anglia (UEA). s.hammond@uea.ac.uk
Contact information
Public, Scientific, Principal investigator
UEA
Norwich Research Park
Norwich
NR4 7TJ
United Kingdom
 ORCID ID |
0000-0002-0473-3610 |
|---|---|
| Phone | +44 1603 591460 |
| s.hammond@uea.ac.uk |
Study information
| Primary study design | Interventional |
|---|---|
| Study design | LIMITLESS II is a Multi Work Package programme of research. Work Package 2 is a multi-center realist evaluation Work Package 3 is a co-design phase Work Package 4 is early user testing using action research Work Package 5 is a multi-center interventional feasibility trial |
| Secondary study design | Non randomised study |
| Scientific title | Optimising the deLIvery of Mental health support to adolescents in care vIa lowinTensity LifE Story work: a realist evaluation with co-deSign and feasibility trial [LIMITLESS II] |
| Study acronym | LIMITLESS II |
| Study objectives | Optimising the delivery of mental health support to adolescents in care via low-intensity Life Story Work will improve carer closeness and teen's well-being |
| Ethics approval(s) |
Approved 20/02/2024, School of Education and Lifelong Learning Research Ethics Subcommittee (University of East Anglia, Norwich, NR4 7TJ, United Kingdom; +44 1603 591460; s.hammond@uea.ac.uk), ref: ETH2324-1306 |
| Health condition(s) or problem(s) studied | Mental health support for young people aged 12-18 years old with experience of living in out-of-home care |
| Intervention | The intervention arm will be given the LIMITLESS Toolkit to implement. This intervention comprises of resources for teens, carers and social workers to implement. We will assess the acceptability of the intervention and the feasibility of the trial processes (e.g., participant identification, recruitment, randomisation, data collection and completeness) to inform the design of a future substantive impact evaluation. Data will be collected via participant-reported web-based questionnaires at baseline (before carers are given the intervention) and one, three, and six-months post-randomisation. |
| Intervention type | Behavioural |
| Primary outcome measure(s) |
1. Caregiver-reported mental health difficulties in adolescents in care measured using The Brief Assessment Checklist for Adolescents (BAC-A) at baseline, one, three and six months |
| Key secondary outcome measure(s) |
There are no secondary outcome measures |
| Completion date | 31/10/2027 |
Eligibility
| Participant type(s) | Service user |
|---|---|
| Age group | Mixed |
| Lower age limit | 12 Years |
| Upper age limit | 100 Years |
| Sex | All |
| Target sample size at registration | 80 |
| Key inclusion criteria | Current key inclusion criteria as of 17/06/2026: Work Package 2 Carer or Social Work Professional: 1. A carer who supports (directly or in-directly) young people aged 12-18 years old living in care Young person: 1. A young person aged 12-18 years currently living in care Work Package 3 Carer or Social Work Professional or Young Person: 1. Above 16 years old, are a care leaver and have experience of living in social care as a young people at some point between ages of 12-18 year old, or you have experience of working in social care and supporting young people aged 12-18 year old Work Package 4 Carer: 1. Currently looking after an adolescent aged between 12-18 years who has been in placement for at least 4 weeks 2. Any placement (foster, kinship foster, residential) Young Person: 1. Aged 12- 18 years old 2. Currently living with an eligable carer Social Care Professionals: 1. Plays a role in supporting an eligible carer and/or young person Work Package 5 Carers: 1. Looking after an adolescent aged between 12-18 years with no moves planned in next 6 months 2. Offering any placement (foster, kinship foster care) in England Young person in care: 1. Living with an eligible carer 2. Able to consent in 14 days of their carer giving informed consenting Social Care Professionals: 1. Plays a role in supporting an eligible carer and/or young person _____ Previous key inclusion criteria: Our unit of analysis will be the carer but we will also asses the feasibility of recruiting and collecting data from adolescents in care. For this feasibility stage, carer recruitment is not contingent on having a paired adolescent recruited into the study, i.e. we are not recruiting dyads. 1. Carers 1.1. Currently looking after an adolescent aged between 12-18 years who has been in placement for at least 4 weeks with no moves planned in next 6 months 1.2. Offering any placement (foster, kinship foster care, residential) 2. Adolescent in care 2.1. Aged between 12-18 years 2.2. In any placement (foster, kinship foster, residential) except where living with their biological parent(s) 2.3. Not currently seeking support from a specialist (tier 3) CAMHS 2.4. No moves planned in next 6 months |
| Key exclusion criteria | Current key exclusion criteria as of 17/06/2026: Work Package 2 Carer or Social Work Professional: 1. Acting as an emergency placement or have an adolescent currently seeking support from a specialist (tier 3) Child and Adolescent Mental Health Service (CAMHS) Young person: 1. Currently seeking support from a specialist (tier 3) CAMHS with no moves planned in next 6 months Work Package 3 Carer or Social Work Professional or Young Person: 1. Not able to attend all three workshop events Work Package 4 Carer: 1. Acting as an emergency placement 2. Have an adolescent currently seeking support from a specialist (tier 3) CAMHS Young person: 1. NA Work Package 5 Carers: 1. Operating as an emergency placement 2. Took part in Work Package 4 of LIMITLESS II 3. Another carer in your household is already taking part in this study Young person: 1. Under 12 years old 2. Over 18 years old Social Care Professionals: 1. NA _____ Previous key exclusion criteria: 1. Carer 1.1. Offering an emergency placement 1.2. Have an adolescent currently seeking support from a specialist (tier 3) Child and Adolescent Mental Health Service (CAMHS) 2. Adolescent in care 2.1. Below 12 years old 2.2. No carer enrolled in the feasibility trial |
| Date of first enrolment | 01/05/2024 |
| Date of final enrolment | 31/12/2026 |
Locations
Countries of recruitment
- United Kingdom
- England
Study participating centres
Martineau Lane
Norwich
NR1 2DH
England
Russell Road
Ipswich
IP1 2BX
England
Pegs Lane
Hertford
SG13 8DQ
England
Market Rd
Chelmsford
CM1 1QH
England
Loughborough Road
West Bridgford
Nottingham
NG2 7QP
England
County Hall
Northallerton
DL7 8SB
England
5 Pancras Square
London
N1C 4AG
England
Results and Publications
| Individual participant data (IPD) Intention to share | Yes |
|---|---|
| IPD sharing plan | Available on request from s.hammond@uea.ac.uk |
Editorial Notes
17/06/2026: The following changes were made to the study record:
1. The study design was changed from "Multi-center interventional feasibility trial" to "LIMITLESS II is a Multi Work Package programme of research.
Work Package 2 is a multi-center realist evaluation
Work Package 3 is a co-design phase
Work Package 4 is early user testing using action research
Work Package 5 is a multi-center interventional feasibility trial".
2. The Health condition(s) or problem(s) studied was changed from "Well-being" to "Mental health support for young people aged 12-18 years old with experience of living in out-of-home care".
3. The key inclusion criteria were changed.
4. The key exclusion criteria were changed.
5. The Date of final enrolment was changed from 31/07/2024 to 31/12/2026.
12/09/2024: Sponsor email was corrected.
19/04/2024: Trial's existence confirmed by University of East Anglia.
