Is it possible for pupil welfare teams to work in a health promoting and preventive way?

Is it possible for pupil welfare teams to work in a health promoting and preventive way?

The research about pupil welfare teams presents a rather problematic picture. The teams seldom function the way they are supposed to. Problems have been identified in interprofessional cooperation within the teams, in the relation between the team and the teachers, with leadership, in perspectives on school problems and so on.

Perhaps most importantly, teams seem to work a lot with “fire-fighting”, i.e. acting after problems have occurred instead of working with health promotion and prevention of problems. Health promotion and prevention of problems have for a long time been pointed out to be the desired way to work, yet it seems to be hard to achieve in practice.

There is some research evidence that university-driven programs can help schools  work more in line with what is prescribed, yet such changes seem hard to be made sustainable, as expressed in the following quote from what seemed to be a successful project:

“Results signaled 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”.

Thus, when we came across a pupil welfare team that seemed to have established health promotive and preventive strategies all by itself without any intervention from the inside, we found it fruitful to make a case-study of this school (see link below to the article on which this blog is built). So how can the school studied be described?

The Castle school 

The school is situated in a municipality with about 25.000 inhabitants recruiting pupils from mixed socioeconomic backgrounds and providing education from 1-9 grade. At the time of the study the school had 600 pupils with several pupils with a refugee background. All 63 teachers in the school were certified teachers and many had worked at the school for a long time. The two principals taught at the school before beginning to work as principals in 2004. The school had an impressive record because practically all pupils had become eligible for upper secondary education for many years (against a national average of about 85 % per year). Yet the educational attainment more generally was not outstanding. The pupil welfare team involved 13 persons. The pupil welfare team in Swedish schools is supposed to be multi-disciplinary and to work with learning, health and psychosocial issues.

Research questions

Two research questions guided the study: (1) Is the studied team working in a health promoting and preventive way? and (2) If so, how did their way of working emerge and how is it sustained? A huge data-material encompassing participant observation, recording of team-meetings and interviews of the team, questionnaires to the teachers, interviews with both principals (one was specifically responsible for the team) and a focus-group with pupils.

All this material was used to evaluate if the team worked in a health promoting and preventive way. It did seem that this was the case, especially when compared to patterns found in prior research. The material was further used in order to try to understand how this line of work had evolved and how it was sustained.

Emergence and sustainability of the teams work

We identified a number of factors that seemed important in order to understand the emergence and sustainability of the team´s work: 1) the mutual vision of the team shared by the school leaders when they became principals in 2004 (i.e. that the team should work in a new way and be a vehicle in preventing school failure) 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 5) the availability of the team for the teachers (a lot of effort was put into establishing a routine where teachers came to the team before big problems had evolved) 6) regular meetings with newcomers in the 7th grade (in order to bridge the acknowledged gap between sixth grade and lower secondary school) 7) the turning of specific problems for problems into general issues (such was the case with the problem of speech anxiety where the proactive, general measures were taken to deal with what prior had been viewed as an individual problem) 8) the importance given to the work of the pupil welfare team when hiring new teachers who were supposed to work according to the routines of the team if hired 9) the ways to avoid problems involved with issues of confidentiality because of different rules for different agencies (i.e. especially between the school and the social services) 10)  reflection meetings devoted only to the team reflecting on their own work 11) the visibility of the team in the school environment and the importance given to the building of relations with the pupils 12) the idea that the work should be guided by a salutogenic perspective 13) the view of teachers as competent, knowledgeable and experienced.

Knowledge contribution

It is of course not easy to exactly establish the importance of each factor and how they affect each other. However, given that prior research to a large extent has identified shortcomings in the work of pupil welfare teams, the study described here 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.


Larsliden, B. and Nilholm, C.  (2021): Is it possible for pupil welfare teams to work health promoting and preventively? – A case study. International Journal of Inclusive Education. Only available in pre-print:

Is it possible for pupil welfare teams to work health promoting and preventively? – A case study (tandfonline.com)


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