What makes Cambridge Academic Performance different?

What makes Cambridge Academic Performance different?


In 2017 we carried out a systematic literature review to identify the best practice in supporting student mental health. The literature review screened over 2000 pieces of research to identify clinically effective strategies. In June 2018 we presented our research to the Royal College of Occupational Therapy Conference in Belfast.

To our knowledge at that time this was the only comprehensive, systematic literature review to look at best practice for mental health occupational therapists working with students. We base our work on these findings.

Here is a detailed break-down of the work and our findings beginning the implications for the role of occupational therapists within education.

Summary/ Implications for Practice:

• This work highlights an evidence gap for occupational therapy delivered by trained clinicians within an educational setting.

• OT’s could play a key role in education, identifying vulnerable students and preventing escalating mental health issues. We believe OT’s working directly within education removes stigma, increasing access to vulnerable students and enabling early intervention.


  • Early treatment of mental illness is essential. However, 70% of children and adolescents experiencing mental health problems do not receive appropriate interventions at a sufficiently early age, suggesting a need to rethink the current approach to delivery of effective treatment to those most at risk.
  • Schools play a crucial role in young people’s mental healthcare, however, inadequately trained staff can lead to negative experiences of care.
  • A recent Care Quality Commission report found that high-quality mental healthcare for young people requires input from varied professions, including occupational therapists (OT’s).
  • Cambridge Academic Performance (CAP) fuses OT techniques with practical academic performance strategies, identifying vulnerable students through their deteriorating academic performance and delivering a clinical level of support within an educational setting.
  • Currently, OT’s are not widely represented as mental health practitioners in education, however, from CAP’s experience, practical approaches (encompassing problem solving, social skills and cognitive behavioural therapy [CBT]) offered by OT’s appear to quickly and effectively provide positive results.
  • A systematic literature review (SLR) was conducted to identify published evidence for OT-based approaches in mental healthcare for vulnerable populations in the educational setting.


  • Searches were conducted in MEDLINE, MEDLINE In-Process, MEDLINE Epub Ahead of Print and Embase simultaneously via the Ovid SP platform, the Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews (CDSR) and Database of Reviews of Effects (DARE) via the Wiley Online platform on 23/06/2017.
  • Further targeted searches of the British Education Index (BEI) and Education Resources Information Center (ERIC) were conducted via the EBSCO platform on 08/02/2018.
  • A publication date limit of 2007 onwards was applied to ensure only data reflecting current and recent practices were identified.
  • Each record was assessed by two independent reviewers using a two-stage process. At stage 1, title and abstracts were reviewed against pre-specified eligibility criteria, full texts of any records deemed potentially relevant were reviewed against the same eligibility criteria at stage 2 (Figure 1 on Conference Poster).
  • Supplementary searches of three relevant congresses and manual searches of relevant SLR reference lists were conducted.
  • Pre-specified characteristics including study design, participant characteristics and results were extracted. The quality of each randomised controlled trial (RCT) and non-RCT was assessed using validated checklists.3,4


  • A total of 2,413 records were identified, of which 2,197 were excluded after title/abstract review and 207 after full-text screening. With 5 publications identified through manual searches, a total of 14 publications, reporting 11 studies, were included.
  • Of the 11 studies, 10 used CBT-based treatment. The other treatment involved mindfulness-based stress management.
  • There were 8 RCTs, all investigating the impact of CBT-based therapies. One non-comparative mixed methods study and two single arm trials were also identified.
  • Treatment was delivered by trained clinicians in 5/11 studies, facilitators, with 4 hour to 2 days of training, in 3/11 studies, and teachers in 3/11 studies.

Summary of results

Treatments delivered by trained clinicians demonstrated improved outcomes for the treatment groups in 5/5 studies, while those delivered by facilitators showed significant improvements for the treatment group in just 1/3 studies.

Of the treatments delivered by teachers, results were mixed. Of the two non-comparative studies, one showed a significant improvement post-treatment and the other showed some improvement in anxiety but not in psychological adjustment. However, the one comparative study using teachers showed no significant difference between the treatment and control groups.


  • This evidence suggests that CBT is the most commonly used treatment option using OT-principles in the educational sector, likely due to its strong clinical evidence base.
  • Whilst treatment effect was variable, this evidence indicates that CBT delivered specifically by clinicians was more beneficial than when delivered by teachers or facilitators who had received brief training in the programs.
  • Applying the CBT approach to meaningful activities for students is a core OT skill.