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School-based counselling has become a prevalent mental health and wellbeing provision for young people in the UK, showing significant effectiveness in reducing psychological distress. Evidence indicates that such counselling not only helps alleviate emotional issues but also enhances students' academic engagement and behaviour. Despite the need for more rigorous studies, preliminary data support its positive impact on young people's mental health and their capacity to participate in education.
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Pushkin
- 1. The effectiveness of school-basedcounselling with young people Mick Cooper, Professor of Counselling EAC, Pushkin 2013 Thanks to: Jo Pybis, Katherine McArthur, Karen Cromarty, Andy Hill, Nancy Rowland, Jamie Murdoch, Nick Turner, Ruth Levesley, Peter Pearce, Sarah Osman, Ros Sewell Contact: [email protected]
- 2. Aims of talk 1.Review evidence from UK on school-based counselling and its effectiveness 2. Explore pathways by which school-based counselling might bring change about
- 3. The emergence ofschoolbased counselling for young people in the UK 1960 1970 1980 1990 2000 2010 Source: Baginsky, 2004; BACP 2012
- 4. Widely disseminated • Today,school-based counselling is one of the most common mental health and wellbeing provisions for young people in the UK Source: BACP 2012; Hill, 2011; estimated figures
- 5. Dissemination of school-basedcounselling in UK secondary schools Scotland: 64-80% (approx.) NI: All schools since 2007 England: 61-85% (approx.) Wales: All schools since 2008 Source: BACP 2012; estimated data for England and Scotland
- 6. International prevalence • 39countries around globe mandate school-based counselling (inc. Czech Republic, Slovakia and Romania) • 24 countries: well-established but not compulsory (inc. Georgia, England) • „Overall, school counselling is developing relatively quickly into an integral part of the education system in many parts of the world‟ (Harris, 2013)
- 7. Service delivery inUK • Delivered by qualified counsellors • Primarily humanistic/integrative, orientation: relational, supportive, „nondirective‟ practice • Generally one-to-one, confidential • Orientation to mental wellbeing • Mainly for young people: 11-18 Source: Cooper, 2009; Hill, 2011
- 8. Referral routes School staff Self Parents/carers Source:Cooper, 2009; Hill, 2011, estimates from approximately 20,000 young people
- 9. Reported waiting times: relativelybrief 50% 35% 1 week 15% 1 month Source: BACP, 2012; Hill, 2011; approximate data, as reported by school staff and local authority leads
- 10. Psychological difficulties at assessment(SDQ) (counselling) „Normal‟ „Abnormal‟ „Borderline‟ Source: Cooper, 2009, from 611 young people
- 11. Presenting/developing issues 35 Percentage 30 25 20 15 10 5 0 Source: Cooper,2009; Hill, 2011; approximate data from over 20,000 cases
- 12. BME under-represented Percentage 2 1.5 1 0.5 0 Counselling clients AllWales Source: Hill, 2011; data from 11,043 cases
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- 15. YP-CORE: Principal outcome measure for school-based counselling in UK Highertotal scores = More distress
- 16. Change from pre-to postcounselling Counselling consistently associated with significant reductions in psychological distress from beginning to end Meta-analyses, ES= 0.81 – 1.09 from pre- to postOutcome measure score (higher scores mean more distress) Welsh Strategy evaluation 25 20 15 10 5 Pre-counselling Post-counselling Source: Hill, 2011; Cooper, 2009; data from
- 17. In “real” terms… Overthe last week… „My problems have felt too much for me‟ After counselling av. = 1.05 Before counselling av. = 1.87 0 1 2 3 4 Not at all Only occasionally Sometimes Often Most or all of the time
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- 19. The randomised controlledtrial „baseline‟ ‟endpoint‟ Counselling Random allocation Not counselling (e.g., wait-list)
- 20. Global data • School-basedtherapeutic interventions significantly reduce psychological distress (107 studies, mean „effect size‟ = 0.45 = medium effect) • But evidence comes mainly from US studies, CBT/psycho-educational, often group-based • Is counselling, as delivered by UK counsellors, effective?
- 21. „School-based humanistic counselling‟ • Developedas distillation of UK practice • Based on humanistic competences: relational, supportive approach, Rogerian foundations • Four pilot RCTs comparing against waitlist
- 22. School-based humanistic counselling Reduced psychologicaldistress • Combined data from three RCTs with 53 clients in counselling, and 57 in waiting list Large effect • Up to 10 weeks ES = 0.78 of SBHC • Audited for ‘adherence’ to humanistic competences
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- 24. Service user perspectives “Itreally does help you to concentrate better in class cos all your problems are like, sorted, so the teachers probably think it's good.” “I was sad when I went in there cos I lost my grandmother….. She says it goes– she says it goes on in my life, she says she knows how hard it is ...The more and more I do learn from her, the more and more I get happier.” “Yeah it's changed my behaviour a lot.. I can walk away from situations instead of swing punches. Before, if I was fighting and one of my friends would grab me I'd hit „em but now if they grab me I'll get off.” “I have recommended it to my friend, I said it really, really helps, you can talk about anything doesn't have to be a really big problem, just any problem you have -- bullying, relationships, friendships, anything - and she always tries to understand everything you say and even if she doesn't understand you can tell her off and just say, „No you got it wrong,‟ and she listens to everything you're saying, and what I'm describing -- it really helps.”
- 25. Do teachers think counselling ishelpful for clients?
- 26. Helpfulness: Teachers‟ ratings (N= 125 pastoral care teachers) „Extremely unhelpful‟ „Neither helpful or unhelpful‟ „Extremely helpful‟
- 27. Teachers‟ open-ended responses •In general, very positive about the helpfulness of counselling: „I was sceptical to begin with…but it‟s been great, excellent, superb‟ „This is an excellent service which has been of huge benefit to pupils on a short/long term basis‟ „Excellent resource which pupils find very valuable‟
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- 29. Global data • Schooltherapeutic interventions significantly improve academic work (83 studies, overall effect size = 0.38) – – – – Class behaviour (teacher-rated): ES = 0.26 Academic achievement: ES = 0.36 Environmentally-related: ES = 0.26 Self-reported academic outcomes: ES = 0.59
- 30. Educational impact: UKdata • Self- and teacher-rated impact on: Motivation to attend / Ability to concentrate / Motivation to study / Willingness to participate in class • Clients: – Improved: 60-70% – Same: 25-35% – Worse: 5-10% • Teachers – Improved: 75-90% – Same: 5-20% – Worse: 2-3%
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- 32. Follow-up data: YP-CORE 25 counselling 20 15 10 6months endpoint midpoint startpoint 5 n = 17
- 33. Case controlled data:YP-CORE 25 counselling 20 15 10 6 months endpoint midpoint startpoint 6 weeks pre 12 weeks pre 5 n = 11 (n = 5 at 6 months)
- 34. How might school-basedcounselling help to bring about individual change?
- 35. Helpful aspects: young people 1. 2. 3. 4. Opportunityto talk and being listened to Getting things off one‟s chest Confidentiality Counsellors‟ personal qualities (e.g., accepting) 5. Independence of counsellor 6. Directive therapeutic interventions (e.g., relaxation exercises)
- 36. Helpful aspects: school staff 1. 2. 3. 4. 5. 6. Accessibilityof service Independence Confidentiality Specialist training Available for extended time periods Non-stigmatising
- 38. Summary 1. School-based counsellingis major area of development internationally 2. Increasing evidence that significantly reduces young people‟s levels of psychological distress, and their ability to engage with education 3. Gives young people an opportunity to talk through problems and feel better about selves
- 39. Summary • School-based counsellingis a widely disseminated intervention, but rigorous evidence of effectiveness is limited • Emerging body of evidence suggests that it does bring about significant reductions in psychological distress • Matches many clients‟ experiences of counselling and cohort data
Editor's Notes
- #23 Actually, really not at all. Without humanistic counselling over a 12 week period really didn’t do well, while those who received it improved very substantially