Special issue: Youth work and social pedagogy
Introduction
This article examines the value of social prescribing as an intervention that addresses social and psychological challenges and promotes agency and well-being among children and young people. By bridging gaps between education, health and social care, social prescribing offers a relational and preventative model of support for young people who may otherwise fall through the cracks of statutory provision. Drawing on findings from a recent evaluation (Hill et al., 2023), the article highlights the potential of social prescribing to address wider social determinants of health, particularly for young people experiencing school refusal, social anxiety and bullying. The findings underscore the importance of holistic, strengths-based approaches that integrate youth work and social pedagogy, reinforcing the potential of social prescribing in responding to complex social and mental health needs.
Young people’s mental health is currently experiencing a profound global crisis, with substantial increases in anxiety, depression and emotional dysregulation across diverse cultural and socio-economic contexts (McGorry et al., 2024; Racine et al., 2021; World Economic Forum, 2024). This has been exacerbated by the Covid-19 pandemic and its aftermath, alongside the intensifying pressures from digitally saturated environments, social disconnection and ongoing mental health stigma (Frentzen et al., 2025; Marciano et al., 2022). These trends highlight the limitations of dominant biomedical approaches, which prioritise individual pathology and medication, marginalising social, relational and community-based forms of support (Weinrabe et al., 2025). As a result, interventions addressing the social, cultural and structural determinants of distress remain underdeveloped, despite growing evidence of poor or worsening outcomes for many young people.
Policy discourse has recently begun to acknowledge the need for support ‘beyond pills’, with calls for a rebalancing towards social interventions and community-based provision (APPG, 2024). Social prescribing represents one such response. Originating within health care, social prescribing is a relational, community-orientated approach that connects individuals to non-clinical forms of support, fostering well-being, resilience and social connection (Henry, 2025). This article argues that social prescribing aligns closely with the principles of social pedagogy and youth work through its emphasis on relationships, participation and learning within community contexts. Drawing on the evaluation data, we explore how social prescribers operate as both the ‘first and last link’ in a connected chain of support, accompanying young people through key transitions in their lives (Hill et al., 2023). Within systems historically orientated towards clinical interventions, community-based social support has long been a critical missing link, and the emergence of social prescribing exposes the limitations of market-driven, siloed commissioning models, which struggle to accommodate relational, preventative and place-based forms of practice. Social prescribing operates at two interconnected levels: at the individual level, it supports agency and self-efficacy; at the systemic level, it promotes cross-sector collaboration and more integrated models of care. This dual function aligns closely with current policy priorities, including Working Together to Safeguard Children (Department for Education, 2023), which emphasises early help and coordinated, multi-agency responses.
The article proceeds by outlining the development of social prescribing, before examining its synergies with youth work and social pedagogy. It then introduces the Connect Together project and discusses the implications of the findings for practice, policy and integrated support for children and young people.
What is social prescribing?
Social prescribing is a person-centred, community-based approach to support, enabling individuals to be connected with non-clinical resources and relationships within their local communities to improve health and well-being. Most commonly facilitated through a supported referral process, social prescribing moves beyond biomedical and deficit-focused models of care by recognising the social, relational and structural determinants of health. While often described as a recent innovation within primary care, our data illustrated that social prescribing has a much longer lineage rooted in youth and community work and in earlier models of community-based social work, which prioritised relational practice, informal education and collective support (Turbett, 2024). Underpinned by a social pedagogic philosophy, social prescribing emphasises values of inclusion, dignity, mutuality and ‘working with’ rather than ‘doing to’. It seeks to reduce barriers to access by offering flexible, non-stigmatising forms of support that are embedded in everyday community settings. For children and young people in particular, social prescribing provides an alternative and complementary response to mental distress, one that resists the over-medicalisation of social and emotional difficulties and instead foregrounds connection, belonging and agency. By strengthening collaboration between schools, community organisations and health services, social prescribing operates as a preventative and relational intervention that responds to complexity, context and lived experience rather than diagnostic thresholds alone.
Since the late 1970s there has been an intentional destruction of more traditional open-access youth and community provisions, as part of wider efforts to reduce and remodel public services (UNISON, 2016). The resulting fragmentation of universal provision and support for young people has led to a shift towards predominantly targeted provision, with services increasingly offered only to those who have been formally identified as ‘at risk’ (Davies, 2013). Pressures, including social isolation, family stress, rising poverty and digitally mediated environments, continue to undermine young people’s mental well-being. The growing demand for mental health and social support from young people within general practice and wider health services highlights the urgent need for systemic change in how support is conceptualised and delivered. There is increasing concern that mental health needs in children and young people are under-recognised; and yet, when identified, these needs are frequently problematised and over-medicalised in clinical settings. Our analysis suggests that what is required instead is a broader, holistic approach to support that moves beyond narrow pharmaceutical and clinically driven interventions (Moncrieff et al., 2011, 2023). Central to this shift is the development of inclusive, community-based preventative approaches that reduce barriers to access and strengthen collaboration between schools, community services and health care providers (Bjørlykhaug et al., 2021). The result is an unprecedented level of mental distress that demands innovative, flexible and contextually responsive forms of support. Recent findings from the Children’s Commissioner indicate that demand for children’s mental health services is rising far more rapidly than the investment needed to sustain them. In 2023–4 alone, almost 60,000 children in England were referred while in mental health crisis, representing more than 6 per cent of all referrals that year, and a further 50,000 children with active referrals were still waiting to begin treatment by the end of March 2024 (Children’s Commissioner for England, 2025).
Young people with mental health disorders are disproportionately more likely to engage in risky behaviours than their peers. Evidence indicates that 25.5 per cent of 11–16-year-olds with a diagnosed mental disorder have self-harmed or attempted suicide, compared to 3 per cent of those without a disorder (Bould et al., 2019). They are also more likely to use tobacco, alcohol and illicit substances, and face a significantly increased risk of school exclusion (McManus et al., 2019). These data illustrate the far-reaching and interconnected impacts of mental distress on multiple domains of young people’s lives and underline the need for targeted, integrated support. At the same time, rising demand has placed significant pressure on services, resulting in long waiting times and limited access to timely support. A Young Minds (2019) survey reported waiting periods of up to 40 weeks, described by young people as ‘soul destroying’, during which mental health frequently deteriorated, with increased self-harm and suicidal ideation. This points to an emerging crisis not only in young people’s mental health, but also in the capacity of services to respond effectively. The situation is further compounded by sustained disinvestment in youth services, with funding reductions of approximately 73 per cent over the past decade (YMCA, 2023), leading to widespread service closures and the loss of qualified youth workers. The erosion of these relational, preventative supports has left many young people increasingly isolated, heightening the risk of long-term harm.
The World Health Organization (2024) reports that 50 per cent of mental health conditions emerge by the age of 14 and 75 per cent by the age of 24, yet many of the conditions remain undetected. In response, the World Health Organization advocates prioritising non-pharmaceutical interventions that uphold children’s rights under the United Nations Convention on the Rights of the Child (UNCRC), including the right to the highest attainable standard of health and the social conditions necessary for healthy development (UNCRC Articles 24, 17 and 27). Mental health is closely linked to physical health, social participation and economic outcomes, with mental disorders accounting for nearly a quarter of the overall burden of illness in the UK. Mental distress is also strongly shaped by structural factors such as poverty, employment insecurity and housing conditions (Knapp and Wong, 2020). Findings from our evaluation indicate that rising levels of social isolation and mental distress among children and young people are frequently compounded by poor diet and lack of sleep, factors well established as contributors to poor mental health across the life course (Bruce et al., 2017; Evidence Based Practice Unit, 2020; Hepsomali and Groeger, 2021). Addressing issues such as nutrition and sleep requires more than information provision; it requires context-sensitive material and relational support, particularly given the close association with poverty and social inequality. Young people’s well-being must also be understood within digitally saturated environments and family contexts characterised by economic pressure and limited time. These conditions reinforce the need for holistic approaches that extend beyond clinical models to address the social determinants of health. Social prescribing seeks to respond to these challenges by integrating youth work and social pedagogic support, though its potential remains constrained by wider market-driven commissioning frameworks.
Our research found social prescribing to be particularly effective for children and young people (Hill et al., 2023), although this requires a broader and more responsive remit than adult-focused models. While adult social prescribing often emphasises advice, information and signposting, provision for young people necessitates a more active, developmentally attuned approach. Social prescribers must facilitate engagement directly, ensuring young people are not simply directed towards opportunities but are supported through the early stages of participation. This often involves being physically present at initial activities and providing reassurance until confidence and familiarity develop. In our study, this hands-on support enabled young people to build confidence, establish community connections and gradually move towards independent engagement. This approach reflects Vygotsky’s (1978) concept of scaffolding, whereby structured support is provided within the young person’s zone of proximal development and gradually withdrawn as competence increases. It also aligns with a ‘holding approach’ (Corney et al., 2024), in which graded, relational support acts as a bridge to wider community participation. From an ecological perspective (Bronfenbrenner, 1979), the social prescriber functions as a consistent and trusted figure within the young person’s microsystem, while facilitating connections across the mesosystem. For many young people, the prescriber represents a significant adult presence, someone reliably available during periods of transition, uncertainty or vulnerability, supporting emotional regulation, trust-building and social learning. The role of the social prescriber is therefore defined by a commitment to ‘walking with’ and ‘working with’ young people in a participatory and relational manner (Laredo and Chiosso, 2018). Positioned as both the first and last link in a network of support, prescribers help young people navigate fragmented systems and build confidence to access wider community resources (Social Prescribing Youth Network, 2025). This role requires a combination of practical, emotional and problem-solving skills, alongside the ability to manage complex caseloads with openness, empathy and reflexivity. Effective practice depends on strong communication, deep listening and a willingness to engage with diverse psychosocial approaches, enabling prescribers to adapt support to young people’s evolving needs and identities (Bertotti, 2024).
Social prescribers also act as key connectors, linking primary care with wider services in health, education, youth work, housing and community development. By helping young people navigate often complex or fragmented systems, they widen access to meaningful opportunities and holistic support. High-quality practice further requires awareness of structural inequalities, including poverty, racism, gendered expectations, disability and other forms of marginalisation. This critical lens supports empathetic responses, avoids deficit-based thinking and strengthens advocacy. The practices we observed closely reflected principles of social pedagogy, emphasising relational work, partnership, empowerment and seeing the whole person within their social world. Synergies were evident in the focus on trust, supportive learning environments and working alongside young people to build resilience and belonging. These elements resonate with Eichsteller and Holthoff’s (2011) account of social pedagogy, particularly the emphasis on relational practice, seeing the whole person, and creating environments that nurture belonging, capability, and agency. They also align with Jeffs and Smith (2010) conceptualisation of youth work, which stresses informal education, voluntary participation, association and working alongside young people rather than doing things to them. Social prescribing, as observed in our study, sits at the intersection of these traditions: it is relational, educative and rights-affirming, supporting young people to develop resilience, voice and meaningful connections. In this commitment to nurturing strengths, capabilities and potential by supporting the holistic development and well-being of young people, the shared values, goals and methods of these methodologies become apparent. There are clear commonalities and reflexive dynamism across both practices, which evolve in tandem with young people rather than being done to them. Success is grounded in the principle of starting where young people are at, not imposing predetermined outcomes, but co-creating solutions and adapting practice as circumstances change. Social pedagogy is underpinned by an intrinsic belief that people’s circumstances can be decisively influenced through education (Hämäläinen, 2003). In youth work, similar ideas of informal education sit at the heart of practice, with learning emerging through conversation, shared experience and the progressive enlargement of young people’s horizons, as Jeffs and Smith (2005) argue: ‘Our task is to work with people so that they may have a greater understanding or appreciation of their experiences. Through coming to understand what might be going on people can begin to be “set free”, not be dictated to by, or victims of, experience’ (pp. 58–9).
Social pedagogy and youth work are complementary traditions that share a belief in the transformative power of relationships, inclusion, participation and informal education. Both disciplines challenge transactional, individualised models of care, offering instead a relational, developmental and socially conscious approach to working with young people. Both approaches are underpinned by a holistic view of young people, recognising them as whole individuals whose intellectual, emotional, social and practical needs must be considered together, situating young people within their social and community contexts, and recognising the importance of relationships, networks and place in identity formation and well-being. Central to this approach is the idea that the practice is grounded in the presence of solidarity and care as a theoretical and ethical viewpoint and the model is shaped by a system that promotes a head, heart and hands methodology to practice. This model is a foundational concept within social pedagogy, offering a holistic framework for understanding professional practice. It emphasises working with the whole person, both practitioner and young person, by integrating knowledge and critical reflection (head), practical action and skills (hand), and relational, emotional and ethical engagement (heart). Central to the model is the balance between thinking, doing and being, recognising that effective practice emerges through the dynamic interplay of these dimensions rather than through technical expertise alone (Cameron and Boddy, 2005; Hill and Laredo, 2019). Both approaches work from a strengths-based perspective, identifying what young people can do, what they care about and what capacities they bring to their environments. This includes an emphasis on informal learning, growth through everyday experiences and developing life skills, not just academic or vocational training. For both social pedagogues and youth workers the importance of the work is grounded in building positive and trusting relationships with young people (Eichsteller and Holthoff, 2012). Youth workers understand the need to build authentic, trusting and respectful relationships with young people, often developed over time and based on mutual engagement, the space which social pedagogues identity as the ‘The Common Third’ (ThemPra Social Pedagogy, n.d.) – a space that is safe and where trusting relationships can be built. The similarities between the disciplines can be measured in the emphasis on building positive, heathy and transparent relationships which value emotional presence; being available, attuned and responsive to the emotional lives of young people; and recognising that change often happens in the context of caring and consistent relationships.
This relationship of the youth worker, the social pedagogue and the social prescriber can be understood by being available, by walking alongside rather than directing or managing. These are all disciplines underscored by a commitment to young peoples’ rights, voices and active participation and seek to work together with young people to co-produce solutions that work for them (Eichsteller and Holthoff, 2011). In doing so there is a recognition of the young person being at the centre of their own process, becoming an active citizen capable of making change in their own community to the services they use and even shaping policy. This methodology ensures inclusivity, positions learning as a catalyst for social change and emphasises interaction rather than didactic instruction (Freire, 2000). Numerous examples illustrate young people’s active role in co-creating policy and shaping services at the national level, including the Youth Advisory Group and the National Youth Strategy (Department for Culture Media & Sports, 2024, 2025a), as well as the Youth Parliament (Department for Culture Media & Sports, 2025b).There are many and diverse examples of successful youth voice projects, which have young people engaged in local decision making (Laredo and Charlton, 2025).
Methodology
Background to the project
The young people’s social prescribing service under discussion was commissioned as a pilot to test the efficacy of a social prescribing model for children and young people in 2023. The Community Connections service was offered as a distinct pathway within an organisation providing a broader range of services including youth work, family support, counselling and other targeted provision. The intended beneficiaries of the service included socially isolated children, those experiencing low mood or requiring support with emotional well-being and regulation, and those seeking to improve their lifestyle through diet and exercise (Hill et al., 2023). Another intended outcome of the project was to support and promote school readiness for children and young people. The project worked well for this group of beneficiaries; however, the data revealed a much more complex range of referrals and concerns than originally anticipated. These included self-harm, neurodevelopmental disorders, family crises and working with many children and young people who had not engaged with school or education for long periods.
The intervention was designed to support any child or young person referred by a general practitioner (GP), school cluster, early help hub or children’s social care. In practice, referral routes were more varied and diverse than anticipated, with children and young people also able to self-refer or be referred by family members. Self-referral and community-based recommendations became a key point of entry because the provider already had a strong local reputation for delivering high-quality support to children and families. Although these pathways were effective in identifying need, it is important to acknowledge that the referral system itself was not underpinned by a youth-work methodology. The model was framed largely around identifying deficits and problems to be rectified, rather than beginning from young people’s strengths, voluntary participation and interests. What made the intervention successful was not the referral mechanism, but the organisational ethos and the commitment of practitioners to youth-work principles and social pedagogical practice. This emphasis on relationships, participation, strengths and ‘working with’ young people helped reframe what might otherwise have remained a deficit-based intervention.
The immediate priority for the worker was to meet and develop a relationship with the young person, and then get to know their family, carers or wider support network. The purpose of getting to know the young person is to co-construct programme activities with practical and positive benefits, such as sports or dancing, as well as to encourage engagement with existing youth groups and positive social connections. A key foundation of the programme is the development of social and emotional skills, building young people’s confidence, sense of agency and capacity to participate
Data collection and analysis
This research formed part of a larger qualitative study examining the efficacy of social prescribing within community health services. Ethical approval was granted by the university ethics committee. The data included 10 semi-structured interviews with social prescribers, 20 individual observations of young people across home, school and activity settings, and six focus groups with young people. A multi-method approach was used, combining observation, interviews, focus groups and organisational quantitative data. Data were analysed using reflexive thematic analysis (Braun and Clarke, 2022) through six phases: familiarisation, coding, theme development, review, definition and report production. This process identified five key themes:
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connected communities
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feeling supported, connected and included
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a whole-family approach/‘no wrong door’
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feeling confident and supported
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developing emotional resilience.
Thematic analysis was then applied to evaluate project outcomes, with a focus on whether social prescribing could address health inequalities. The evaluation examined changes in children and young people’s mental health, social well-being and holistic aspects including physical health, emotional well-being, social connection and feeling safe. The evaluation also explored the benefits of social prescribing with direct reference to feelings and behaviours, friends, improvements in attendance and attainment at school, and improved confidence and self-esteem.
In addressing the research aims and objectives, we employed a flexible approach to data collection within an overarching qualitative framework. This included participant observation, where we sat alongside social prescribers, as well as interviews with key stakeholders, including GPs, social workers, parents/carers and the young people themselves. The voices and experiences of children and young people were central to our research. To foreground their perspectives, we adapted our approach as needed: if a young person was initially hesitant or unwilling to talk, we engaged with them supportively, at their own pace and in a setting of their choice, ensuring they were comfortable throughout the process.
Goal-based outcomes
In addition to qualitative data, the evaluation employed multiple quantitative tools to measure and track young people’s progress. These included goal-based outcomes, which were used at the outset of the intervention and at subsequent review points to capture young people’s perceptions of progress towards personally identified goals (Law and Jacob, 2015). The Outcomes Star (https://www.outcomesstar.org.uk) was also used as a collaborative tool to map and monitor change across key domains, including emotional well-being, social connections and home life. Closely aligned with the principles of social pedagogy and youth work, the Outcomes Star supports reflective, relational practice by positioning young people as active participants in assessing their own development. Through a combination of self-assessment and practitioner facilitation, the tool enables strengths-based dialogue, goal setting and responsive adaptation of support, while providing both a visual representation of change and a structured means of foregrounding young people’s voices.
During the period of the evaluation 111 young people were seen and although not all their feedback was captured in qualitative evaluation, their progress was measured using a service effectiveness questionnaire. The data showed:
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88 per cent reported an improvement in emotional and mental well-being
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60 per cent reported an improvement in their physical health
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78 per cent reported they felt they could better manage problems/challenges
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72 per cent reported that their ability to make good choices had improved
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71 per cent felt their circle of support (friends and family) had improved (Hill et al., 2023).
Discussion and findings
A community-based approach to social prescribing
One of the highlights of the evaluation was observing the successful operationalisation of the model and its tangible, positive impact on the lives of children, young people and families. At the heart of the model was a commitment to integrating clinical and community-based approaches through social prescribing, achieved by scaffolding individual casework with community support. The adaptability embedded within the model was particularly valuable, as it acknowledged children and young people as complex individuals situated within wider family and community systems. This whole-family approach ensured that families received the right support at the right time and in the right place. Complementing this, the model adopted a ‘no wrong door’ philosophy, meaning that children, young people and families could access support through any entry point, whether a GP, school or community organisation, and still receive coordinated, holistic care. Practitioners worked across services to ensure that needs were met effectively, reflecting both social pedagogical and youth work principles of accessibility, inclusion and relational, strengths-based support. The success of the intervention stemmed from the organisational ethos and the approach of practitioners and their commitment to youth work principles, as articulated by Jeffs and Smith (2010). At the same time, practitioners applied core social pedagogical principles, as described by Eichsteller and Holthoff (2011, 2012), based on building relationships, nurturing capabilities and seeing young people as whole individuals within their social worlds. This combination of approaches ensured that the intervention was not merely corrective but relational, empowering and responsive to young people’s strengths, interests and aspirations.
The intervention was pragmatic in responding to both the child or young person’s needs individually and prioritising their needs, while simultaneously accommodating parents and sometimes grandparents who may form part of the child’s wider social network. The quote below captures this positivity but offers a critique of contemporary policy and funding. The time-limited nature of support reflects the market driven business model of youth support in a contemporary society; a limiting support that offers silo-based temporal support rather than permanent and secure provision, it is essentially reactive rather than preventative:
They've been great, they support all of us, it’s just a shame it doesn’t last that long, it seems like you get to know people and it’s time to end. (Young person 5 quoted in Hill et al., 2023)
The intervention provided much-needed support, but a significant challenge remained: delivering timely and effective interventions within the constraints of a commissioned, time-limited service. These constraints reflect broader neoliberal pressures in public service delivery, where commissioning frameworks often emphasise efficiency, measurable outputs and rapid results. While such approaches facilitate accountability, they risk reducing complex human needs to simplistic, deficit-focused ‘quick fixes’, rather than supporting the ongoing, holistic development of children, young people and families. Social pedagogical and youth work approaches, in contrast, prioritise long-term, relational and strengths-based support, recognising that meaningful change, such as improved well-being, social connectedness and family resilience, cannot be rushed or imposed. Embedding flexibility and responsiveness within the intervention was therefore critical to its success. Despite these challenges, the model demonstrated the best aspects of youth work by working with young people in a dedicated, person-centred manner, while also applying community social work approaches to connect individuals with wider community resources through structured casework (Howe and Hill, 2024; Jeffs and Smith, 2010). The intervention highlighted the importance of meaningful and integrated connections between young people, families and communities. As one young person noted, the combination of community-based visits and one-to-one support had a profoundly positive impact. This account underscores the importance of a trusted, non-familial relationship in facilitating emotional expression combined with the emotional and well-being benefits of being listened to and supported within a relational, rather than purely clinical, framework.
It’s good because I don’t really like talking to people [my parents] about my feelings, but now I do … These last couple of weeks since talking to her [the prescriber] I feel happier. (Young person 2 quoted in Hill et al., 2023)
The following quotes illustrate how relational support can facilitate behavioural change. Through consistent engagement and trust-building, the prescriber creates a space where the young person can reflect on past behaviours and develop new patterns of engagement, highlighting the practical impact of social pedagogic approaches:
I was just getting into trouble all the time … but now I listen more. (Young person 6 quoted in Hill et al., 2023)
I’ve become more sociable, I didn’t really like to be social, but now I talk more to people. (Young person 10 quoted in Hill et al., 2023)
She (social prescriber) helped me with the bullying at school; I can tell the teacher now. (Young person 9 quoted in Hill et al., 2023)
Individual support was complemented by a package of whole-family support, grounded in a model that recognises the interconnectedness of children, young people and their wider family networks. Where appropriate, social prescribers worked with significant others and family members to enhance and amplify the support available, breaking down barriers and supporting the child or young person both at home and in the community. The inclusion of family members proved particularly beneficial for addressing complex issues such as school attendance, self-harm, diet and physical health. Direct and indirect advocacy was a key feature of the intervention, especially with schools, where support helped make children’s needs visible and fostered a better understanding of the challenges they faced. Supporting families in accessing the services they required was also central, with practitioners ensuring that carers were consistently included in the feedback loop. While the primary relationship remained with the young person, the findings highlighted that challenges experienced by a child often had ripple effects across the wider family network.
By building trust and confidence within the wider family, prescribers reinforced a consistent and skills-based intervention model. This approach encouraged families to sustain the support, advice and information beyond the intervention period, ensuring continuity and availability for any necessary follow-up. Working holistically with the whole family played a crucial role in addressing relational challenges and caregiving dynamics. Providing support to the family helped strengthen social bonds and reinforce relationships within the household. Given the short-term nature of social prescribing, practitioners formed pragmatic alliances with family members to embed strategies, activities and ongoing support for children and young people. Additionally, interventions emphasised relationship-building with external organisations, equipping families with the confidence and coping strategies needed to maintain long-term engagement and resilience. One of the parents commented:
They’ve been really good not just with [young person’s name] but also with me, they have listened to me and helped me deal with school. (Parent 4 quoted in Hill et al., 2023)
And another reflected:
It’s always better to have somebody else come in to give that advice because they don’t want to listen to you. (Parent 8 quoted in Hill et al., 2023)
These quotations show the effectiveness of providing emotional support while avoiding the emotional intensity or defensiveness that can arise in close relationships. This creates space for reflection rather than resistance
Physical health
The project also addressed the physical health and well-being of children and young people in a sensitive and informed manner. The complex relationship between physical health and mental well-being is well-documented (Hepsomali and Groeger, 2021), with factors such as inadequate sleep, lack of routine, limited physical activity and poor diet often contributing to difficulties with concentration, fatigue and emotional distress. These challenges are frequently exacerbated by strained relationships at school.
Sleep plays a crucial role in emotional regulation. Young people who consistently obtain sufficient rest are less likely to experience mood disorders (Uccella et al., 2023), whereas sleep deprivation can lead to irritability, mood swings and heightened stress. Although referrals rarely identified sleep as a primary concern, home visits offered valuable insights through informal conversations and observations. It became evident that many young people experienced disrupted sleep patterns, often linked to prolonged engagement with gaming, TikTok or other social media platforms. Recognising the prevalence of sleep-related issues, practitioners began routinely asking young people about their sleep habits. A consistent pattern emerged: many reported insufficient or irregular sleep, which practitioners identified as a key factor affecting emotional well-being, mood regulation and engagement in daily activities. This observation enabled practitioners to explore issues of sleep hygiene and diet and to confidently promote positive routines, working collaboratively with both the young person and their wider family. By building strong relationships with families, practitioners were able to address these multiple, complex and sensitive issues using a whole-systems family approach, recognising the interconnected nature of individual, familial and community well-being.
Being safe
Feeling safe is a complex and personal issue. Many of the young people we observed and interviewed had difficult relationships with places that should provide security, such as school, their neighbourhood and even their social circles. Experiences of anxiety, alienation, bullying and social isolation were often key factors in their referral to social prescribing. As a result, safety must be understood in a nuanced and context-specific way. Social prescribers adopted a practical and relational approach to safeguarding, engaging directly with children and families within the home environment. This approach allowed for a deeper contextual understanding of safety concerns and enabled appropriate safeguarding measures to be explored (Firmin, 2020). Beyond the home, social prescribing interventions also created dedicated time and space for young people in a variety of settings, whether at school, in group activities or through informal interactions such as walking and talking. This flexible and responsive approach ensured that safety concerns were addressed in a way that aligned with the young person’s lived experiences and individual needs. The art of making time and providing support in a timely manner is a central component of a safe space for the young person. As one young person remarked:
My worker makes time for me, she will like just meet me anywhere, at home, at the centre or at school, it’s good to chat and have time for just me. (Young person 3 quoted in Hill et al., 2023)
This account highlights how safeguarding is enacted across multiple spaces rather than being confined to a single setting. The worker’s presence in both school and home reflects a contextual and relational approach, where support travels with the young person across environments that shape their everyday experiences (Firmin, 2020). Moving between school and home positions the worker as a bridge between institutional and private spaces, reducing fragmentation in support and enabling a more holistic understanding of the young person’s context.
The team often had to address complex needs and often some very difficult behaviour, particularly in relation to acts deliberate self-harm. Keeping children and young people safe has been at the core of this activity. Social prescribers delivered support and information to manage and recognise the risk of self-harm undertaking work with both the young person and family. One young person reported:
My Worker helped. I will now ring them if I am feeling like I might harm myself. (Young person 11 quoted in Hill et al., 2023)
Relationships
Interviews with children and young people highlighted that they trust their Connect Together workers and value their input. One young person reported:
I like [Connect Together Worker] they come see me at school and at home, they are nice to me, and we talk and do activities. (Young person 5 quoted in Hill et al., 2023)
This comment underscores the importance of affect, trust and emotional safety. The reference to ‘talk and do activities’ aligns with social pedagogical principles of learning and engagement through shared activity, supporting connection without over-surveillance.
The core function of Connect Together is to provide a supportive, helping relationship that situates the young person within a wider network of everyday connections. Support workers build strong, trusting relationships that deliver meaningful social support, going beyond just talk to actively advocate for families, provide practical assistance, and walk alongside them through complex situations.
Many of the young people referred to the project are simultaneously undergoing formal psychological or educational assessments to determine their need for additional support in school. However, this process is often lengthy, complex and characterised by multiple barriers. The resulting sense of being lost reflects how disconnections between services and institutional spaces can intensify feelings of vulnerability and uncertainty for families.
One of the parents commented:
It’s good that they can help you, it’s always a struggle in getting what you need and sometimes it can make you feel lost. (parent 6 quoted in Hill et al., 2023)
Feelings and behaviour
One of the primary referrals for social prescribing centres around support with feelings and behaviours; many of the young people reported feelings of anxiety, low mood and isolation. Others were referred because of self-harm and many have been labelled as different for being neurodivergent and are undergoing or waiting for an assessment for ADHD or autism. In addition, the young people are still coming to terms with the dislocation experienced by the extended lockdown from the Covid-19 pandemic.
When asked about their experiences, many young people described the project’s positive impact, reflecting on the changes they had noticed in themselves as a starting point:
Yeah, I think it’s helped a lot because before I was like, I didn’t know what to do, but she’s told me what to do and it’s like, helped a lot more. (Young person 1 quoted in Hill et al., 2023)
It’s good cos I don’t talk about my feelings, I don’t know how to feel sometimes … I want to understand my feelings more, they frighten me, and I don’t like that. (Young person 2 quoted in Hill et al., 2023)
‘I didn’t know what to do’ reflects the confusion or overload often experienced by young people navigating unsafe or unpredictable spaces. The worker’s role here is to provide the scaffolding and support to help the young person make sense of choices within their context.
With more complex behaviour such as self-harming, project workers supported young people in addressing mood and anxiety and promoting coping skills; they also provided guidance and support in accessing service user-based support and linking in with secondary care child and adolescent mental health services.
Education and learning
Schools were one of the primary referral points, with many young people requiring support due to delays in accessing statutory services such as Children and Adolescent Mental Health Services assessments. Families and young people often needed social support not only to navigate these professional systems but also to understand their own role within them. Family members frequently reported that the social prescriber had been a ‘big help’ in providing in-school support and home-based guidance, assisting them through a system they described as a ‘maze’. Schools can be experienced as complex and intimidating, and having a friendly, supportive advocate helped to demystify processes and reduce anxiety:
They have been so helpful, before our contact I was at the end of my tether and didn’t know where to turn. (Parent 5 quoted in Hill et al., 2023)
[The prescriber] was always patient with the school, that helped me because I didn’t know what to say, and that would make me even more mad, she helped me to see that it wasn’t as bad as I though it was, and that helped me. (Parent 2 quoted in Hill et al., 2023)
The intervention also highlighted the challenges of collaboration across different professional sectors. Practitioners encountered varying work cultures, targets, methods, values and resources, which could complicate joint working. Social prescribers played a crucial bridging role, helping to align these differing approaches while ensuring continuity of support for the young person and their family. This underscores the importance of relational, flexible and system-aware practice in overcoming structural and organisational barriers to holistic care.
The social prescribers worked supportively with children, young people and their families to re-engage and encourage them to access formal education. This process has been intensive with the social prescribers acting as a bridge between the school and family, often working in partnership with education professionals to facilitate engagement while providing direct support to young people to build the confidence to attend, enjoy and thrive at school.
Summary
In our evaluation, we found a model of social prescribing underpinned by social pedagogy as both a nurturing and educative practice offering a new vantage point and framework of intervention for youth work. This model reflects a commitment to walk with and work with children and young people through often complex and challenging life experiences. The social prescriber functions not simply as a signpost to services, but as a relational educator and companion, grounded in the pedagogic belief that learning, growth and care are deeply interconnected. Acting as the first and last link in a wider, interconnected chain of social support, the social prescriber draws on the social pedagogic triad of head (reflection and understanding), heart (empathy and emotional connection) and hands (practical action and skills), offering a holistic, human-centred approach that nurtures both individual agency and collective belonging (Singleton, 2015). The findings from this research also make a clear contribution to youth work practice. Social prescribing in this context demonstrates how youth work principles, voluntary engagement, relational practice and informal education can be operationalised in ways that are both structured and flexible. As Jeffs and Smith (2010) emphasise, youth work relies on building trusting relationships, enabling young people to develop autonomy, resilience and the capacity to participate meaningfully in their communities. The social prescribing model exemplified this approach by combining one-to-one support, group activities and advocacy, ensuring that young people are actively involved in shaping their own development and learning. At the same time, the evaluation identified challenges in the implementation of social prescribing. These included the time-limited nature of commissioned services, navigating complex multi-agency systems, and balancing individual needs with family and community support. Differences in professional cultures, priorities and resources sometimes complicated collaboration, requiring practitioners to act as connectors and advocates.
Importantly, this intervention illustrates how social pedagogy operates as ‘the space where care and education meet’ (Cameron and Moss, 2011). Social prescribers engage in both nurturing and educative work, supporting young people’s well-being while simultaneously promoting learning, skill development and social participation. The approach demonstrates how relational, strengths-based practice can be embedded in everyday interactions, whether through facilitating access to community activities, supporting families or guiding young people through complex systems. In doing so, practitioners enact a hybrid model that integrates youth work and social pedagogy, showing how care, advocacy and education can co-exist in ways that empower young people, strengthen family and community networks, and foster long-term resilience.
By situating social prescribing within this dual framework, the research underscored the potential to extend the reach and impact of youth work, offering a methodology that is both preventative and responsive, relational and educational. It highlights the practical value of social pedagogy as a guide for intervention design and delivery, while simultaneously providing a clear example of how youth work principles can be operationalised in innovative, holistic and outcomes-focused ways.
Social prescribers engage in both nurturing and educative work, supporting well-being while promoting learning, skill development and social participation. The practitioners in the Connect Together project enacted a hybrid model that integrated both youth work and social pedagogy, illustrating how care, advocacy and education can co-exist to empower young people, strengthen family and community networks and foster long-term resilience.
Declarations and conflicts of interest
Research ethics statement
The authors declare that research ethics approval for this article was provided by Leeds Beckett University ethics board. The authors conducted the research reported in this article in accordance with National Youth Agency standards.
Consent for publication statement
Not applicable to this article.
Conflicts of interest statement
The authors declare no conflicts of interest with this work. All efforts to sufficiently anonymise the authors during peer review of this article have been made. The authors declare no further conflicts with this article.
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