Background
"In England, approximately one in seven young people meet criteria for a ‘mental disorder’, with prevalence rates rising over the past two decades. Schools, as recognised by the UK government, may provide an ideal environment to try and address this problem. They provide young people with unparalleled access to services; alleviating barriers such as time, location, and cost."
"One of the most common forms of school-based mental health intervention is counselling. School-based counselling is well established in over 60 countries around the globe, and mandatory in at least 40, including Wales. In England, approximately 60% of secondary schools provide some form of on-site counselling, with approximately 70,000–90,000 young people attending it every year in the UK."
"School counselling in the UK most commonly takes a humanistic (aka ‘person-centred’) form. Here, counsellors provide clients with an empathic, non-judgmental, and supportive relationship to find their own answers to their problems. This form of counselling is not targeted towards specific mental health ‘disorders’ (for instance, depression), but adopts a more general orientation. This may make it particularly appropriate as a ‘first line’ intervention within a school context, where a diverse array of mental health challenges may exist (for instance, bereavement, bullying, and problems with parents/carers)."
"But does this form of school counselling actually help? Data from four small trials have provided some initial indications of effects; and qualitative research suggests that clients, parents/carers, and teachers all tend to perceive it positively. What is missing, however, is a large-scale, robust evaluation of this intervention, which looks at a range of mental health and educational outcomes, follow-up effects, and economic costs; as well as the experiences and perceptions of clients, parents/carers, and teachers."
"In 2016, a team led by the University of Roehampton was funded by the Economic and Social Research Council to conduct such a study, with collaborators at the universities of Manchester and Sheffield; the London School of Economics; Metanoia Institute (London); the British Association for Counselling and Psychotherapy; and the National Children’s Bureau."
Summary
"Our findings suggest that, on average, school-based humanistic counselling can help young people, with effects that persist for at least three months after the end of counselling. The counselling was most effective in helping young people improve their self-esteem and achieve personal goals; least effective at reducing mental health symptoms. In addition, it showed not effect on educational outcomes or reducing other service costs. Such averages, however, can mask differences in the way that young people responded to the counselling: around two-thirds seem to have found it wholly or mostly helpful, another 30% or so found it helped a bit; and then approximately 5% really did not like it. Although there is no clear evidence on who it was most helpful for, our interview data suggests that if young people were wanting—and motivated—to get things off their chests, learn about themselves, and/or find different ways of relating and coping, the counselling may have been most likely to of benefit. On the other hand, if the young people found it difficult to open up, felt uncomfortable talking to others, and/or wanted direct guidance and advice, then this intervention did not seem to be most suited."
"Finding effective ways of addressing mental health problems in young people remains a priority for policy makers and fund holders. Our study shows that school-based humanistic counselling is a viable option, but it is not a ‘magic bullet’. Rather, it is likely to help some young people some of the time, and should be offered to young people as one out of a range of possible interventions. What is most important now is to carry out equally rigorous evaluations of alternative programmes in the UK; and to develop some understanding of which interventions are most likely to be helpful for who."
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