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School-Based Humanistic Counselling:

Evaluation, Evolution and Actualisation

Mick Cooper

Professor of Counselling Psychology, University of Roehampton

Thanks to the many people whose research and feedback contributed to this paper.

Strathclyde colleagues: Susan McGinnis, Dave Mearns, Mike Hough, Lorna Carrick, Lucia Berdondini, Katie McArthur, Tricia Joyce, Carin Killips, Rosemary Lynass, Akvile Daniuiate, ZenibAhmed, Robert Elliott, Gillian Griffiths, project counsellors.

External colleagues: Stephen McLeod, John Butcher, Sal Bennett, Karen Cromarty, Andy Hill, Peter Jenkins, Sylvia Jones, Ruth Levesley, Adam McAdam, Polly Morrison, Jamie Murdoch, Susan Pattison, Anne O'Herlihy, Kathryn Pugh, Jo Pybis, Nancy Rowland, Sheila Spong, Nick Turner, Olga Pykhtina, Kaye Richards, Elspeth Twigg, Michael Barkham, Chris Evans, John Mellor-Clark, Barry Duncan, Jacqueline Sparks, Dave Stewart, Sheila Spong, Andrew Reeves, Peter Fonagy, Miranda Wolpert, Duncan Law, Raph Kelvin

The Glasgow Counselling in Schools Project

• Inspired in 2001 by Susan McGinnis, member of the BACP CCYP Exec and editor of Counselling in Education

• Developed in association with Dave Mearns, Director of the Counselling Unit

• ‘A service that would be in the school but not of the school’

• September 2002: two years’ funding from Greater Glasgow NHS Board for counselling service in three secondary schools

• Mike Hough appointed as Project Manager

• September 2004: projected extended to a further 10 schools in Glasgow – continued until July 2011

• Susan McGinnis project manager from 2004; Lorna Carrick/Mick Cooper as Principal Investigators; Beth Freire coordinated evaluation

Counselling servicesSchool-based counselling services also delivered/ supported in East Dunbartonshire (2002-10), Clydebank, Oban and Tobermory, and Orkney

Service delivery supported by a range of practitioner-based resources from Mike Hough and Susan McGinnis

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and CPD training

• Uniquely, from its inception, evaluation and research were integral to the Counselling Unit’s work

• Came to be leading centre in UK

• Evaluation of both Unit projects and external services: ERYCS, Welsh Assembly Government, Place2Be, Barnardo’s NI, Relate…

Glasgow projects amongst first to use ‘Teen-CORE’ (now YP-CORE) to evaluate change from beginning to end of counselling

Higher total scores =

More distress

Changes in distress

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Change from pre- to post-counselling

Evaluations showed that counselling was consistently associated with reductions in psychological distress

Welsh Strategy datasets

Evaluation of primary-school counselling with ‘systematic feedback’

• The integration into therapy of validated methods that invite clients, on a regular basis, to assess their wellbeing (outcome feedback), or experience of therapy and the therapeutic relationship (process feedback)

• ‘Time4Me’ primary school counselling service

• Goals for counselling agreed at assessment with child and family

• Weekly use of ‘Child Outcome Rating Scale’ and ‘Child Session Rating Scale’ to assess progress and personalise therapy

© Duncan Soar Photography 2011

Time4Me: Start of counselling

Clinical levels of distress

= 73.6%

Time4Me: End of counselling

Clinical levels of distress

= 9.4%

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Children and young people consistently describe school-based counselling as helpful

From Welsh School-based Counselling Strategy:

“It really 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.”

But are improvements just due to demand characteristics, and general changes over time?

5

10

15

20

25

Baseline 6 weeks

Psy

cho

log

ica

l d

istr

ess

(hig

he

r sc

ore

s =

mo

re d

istr

ess

ed

)

Counselling

Counselling

Not counselling

(e.g., wait-list)

‘baseline’ ’endpoint’

Randomallocation

The randomised controlled trial

‘School-based humanistic counselling’

• Developed as distillation of UK practice

• Based on humanistic competences: relational, supportive approach, Rogerian foundations

• Four pilot RCTs comparing against waitlist

Reduce

d p

sych

olo

gica

l distre

ss

School-based humanistic counselling

• Combined data from three RCTs with 53 clients in counselling, and

57 in waiting list• Up to 10 weeks

of SBHC• Audited for

‘adherence’ to humanistic

competences

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Reduce

d p

sych

olo

gica

l distre

ss

• Combined data from three RCTs with 53 clients in counselling, and

57 in waiting list• Up to 10 weeks

of SBHC• Audited for

‘adherence’ to humanistic

competences

School-based humanistic counselling

Large effect ES = 0.78

Self-esteem (SEQ)

12 weeks (sig. diff.)N = 30 (SBHC), 31 (WL)

p = .03ES = 0.46

6 weeks (NS)N = 29 (SBHC), 30 (WL)

p = .28ES = 0.23

Less d

istress

Personal goals (GBOM)

Less d

istress

12 weeks (sig. diff.)N = 18 (SBHC), 24 (WL)

p = .003ES = 0.97

6 weeks (sig. diff.)N = 18 (SBHC), 23 (WL)

p = .049ES = 0.62

Developing RCTs• COSEE trial: Non-directive

play therapy for children

with severe behavioural difficulties

• Moray trial (Tricia Joyce): Comparison of pluralistic counselling and counselling as usual for young people

with issues related to addiction

How might school-based counselling help to bring about individual change?

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Helpful aspects: young people

1. Opportunity to talk and being listened to

2. Getting things off one’s chest

3. Confidentiality

4. Counsellors’ personal qualities (e.g., accepting)

5. Independence of counsellor

6. Directive therapeutic interventions (e.g., relaxation exercises)

Helpful aspects: school staff

1. Accessibility of service

2. Independence

3. Confidentiality

4. Specialist training

5. Available for extended time periods

6. Non-stigmatising

Life difficulties: e.g.,

family break-up,

being bullied

Life difficulties: e.g.,

family break-up,

being bullied

Psychological

distress

isolation

confusionconfusion

worryingworrying

shameshame

Talking

problems

through

Talking

problems

through

understandingunderstanding

warmthwarmth

challengechallenge

Time to talkTime to talk

adviceadvice

finding solutions

confidentiality

ruminating

2009 Comprehensive review

• First comprehensive summary of evidence

from 30 audit and evaluation studies of school-based counselling in the UK

• Established that school-based counselling

was associated with large reductions in

psychological distress

• And that both service users and teachers believed that the intervention was

associated with positive benefits in

mental wellbeing and educational engagement

• Identified characteristics of school-based

counselling service and their users

Review of services across Wales

Data from over 10,000 young people

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Scoping reports: 2013

Available from www.counsellingminded.com

What we learnt about school-based counselling services…

Cases in England (per year)

Specialist CAMHS (79,966,

10-18 year olds, 2008-9)

School-based counselling

(approx. 60,000)

Service delivery in UK• Primarily

humanistic, or integrative, practice

• Emphasis on mental wellbeing

• Generally one-to-one (rather than group or family)

Referral routesSchool staff

Self

Parents/carers

1 week 1 month

50%

35%15%

Reported waiting times: relatively brief

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Psychological difficulties at assessment (SDQ) (counselling)

‘Abnormal’

‘Borderline’

‘Normal’

Presenting/developing issues

0

5

10

15

20

25

30

35

Perc

enta

ge

BME under-represented

0

0.5

1

1.5

2

Counselling clients

All Wales

Perc

enta

ge

Strathclyde research has been presented to politicians and policy makers in Edinburgh, Stormont, Cardiff and

Westminster

Wales: All schools since 2008

NI: All schools since 2007

Scotland: 64-80% (approx.)

England: 61-85% (approx.)

Dissemination of school-based counselling in UK secondary schools

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Wales• 2007 report into counselling services for children and young

people in Wales set ten recommendations that were wholly adopted by the Welsh government

• Became the basis for the provision and delivery of £6.5m

school-based counselling strategy in 2008

• Subsequent 2011 evaluation supported the £14.25m extension

of the Strategy and subsequent establishment of school-based counselling as a constitutional responsibility

• 2012-13: University of Strathclyde co-chaired

development of competences for counselling young

people: will form basis of training programmes and

accreditation

• Drew extensively from research by Robert Elliott and

EFT colleagues; also Robert’s involvement in

development of humanistic competences

• And from Strathclyde school-based research programme

http://www.bacp.co.uk/research/resources/cyp_competences.php

From 2012 to 2014, the Counselling Unit co-led the development of a free e-learning programme for counsellors

working with children and young people

45, half-hour sessions

Funded by the Department of Health

www.minded.org.uk

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www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

www.minded.org.uk

Modules• Introduction to Counselling MindEd

• Counselling and its context

• Participation and empowerment

• Legal and professional issues

• Cultural competence

• Initiating counselling

• Using measures

• Relational skills

• Therapeutic skills

• Developmental themes in young adults and young people

• Concluding counselling

• Using supervision

https://www.minded.org.uk//course/view.php?id=229

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Thank youPublications

• Cooper, M. (2004). Counselling in Schools Project: Evaluation Report. Glasgow: Counselling Unit, University of Strathclyde. Download from

http://www.strath.ac.uk/Departments/counsunit/research/cis.html.

• Cooper, M. (2006). Analysis of the evaluation data East Renfrewshire Youth Counselling Service (ERYCS): Development and evaluation of a full-time secondary school and community based youth counselling service in Scotland 2005. East Renfrewshire: East Renfrewshire Council.

• Cooper, M. (2006). Counselling in Schools Project Phase II: Evaluation Report. Glasgow: Counselling Unit, University of Strathclyde.

Download from http://www.strath.ac.uk/Departments/counsunit/research/cis.html.

• Cooper, M. (2006). Scottish secondary school students' preferences for location, format of counselling and sex of counsellor. School Psychology International, 27(5), 627-638.

• Cooper, M. (2008). The effectiveness of humanistic counselling in secondary schools. In M. Behr & J. H. D. Cornelius-White (Eds.),

Facilitating Young People's Development: International perspectives on person-centred theory and practice (pp. 122-139). Ross-on-Wye:

PCCS Books.

• Cooper, M. (2009). Counselling in UK secondary schools: A comprehensive review of audit and evaluation studies Counselling and Psychotherapy Research, 9(3), 137-150.

• Cooper, M. (2013). School-based counselling in UK secondary schools: A review and critical evaluation. Lutterworth: BACP/Counselling

MindEd.

• Cooper, M., & Freire, E. (2007). Audit and evaluation East Renfrewshire Youth Counselling Service (ERYCS): Review of the Service Including Phase II Evaluation. East Renfrewshire: East Renfrewshire Council.

• Cooper, M., & Freire, E. (2009). Pilton counselling service: Evaluation data analysis. Glasgow: University of Strathclyde.

• Cooper, M., Hough, M., & Loynd, C. (2005). Scottish secondary school teachers' attitudes towards, and conceptualisations of, counselling.

British Journal of Guidance and Counselling, 33(2), 199-211.

• Cooper, M., McGinnis, S., & Carrick, L. (in press). School-based humanistic counselling for psychological distress in young people: A cohort

study using a low attrition sample. Counselling and Psychotherapy Research.

• Cooper, M., Pybis, J., Hill, A., Jones, S., & Cromarty, K. (2013). Therapeutic outcomes in the Welsh Government's school-based counselling strategy: An evaluation. Counselling and Psychotherapy Research, 13(2), 86-97. doi: 10.1080/14733145.2012.713372

• Cooper, M., Rowland, N., McArthur, K., Pattison, S., Cromarty, K., & Richards, K. (2010). Randomised controlled trial of school-based humanistic counselling for emotional distress in young people: Feasibility study and preliminary indications of efficacy. Child and Adolescent Psychiatry and Mental Health, 4(1), 1-12.

• Cooper, M., Stewart, D., Sparks, J. A., & Bunting, L. (2013). School-based counseling using systematic feedback : a cohort study

evaluating outcomes and predictors of change. Psychotherapy Research, 23(4), 474-488. doi: 10.1080/10503307.2012.735777

Publications• Daniunaite, A., Ahmad Ali, Z., & Cooper, M. (2012). Psychological change in distressed young people who do not receive counselling: does

improvement happen anyway? British Journal of Guidance & Counselling, 40(5), 515-525. doi: 10.1080/03069885.2012.718734

• Freire, E., & Cooper, M. (2008). Glasgow counselling in schools project: Evaluation report 2006/2007. Glasgow: University of Strathclyde.

• Hill, A., Cooper, M., Pybis, J., Cromarty, K., Pattison, S., Spong, S., . . . Maybanks, N. (2011). Evaluation of the Welsh School-based

Counselling Strategy. Cardiff: Welsh Government Social Research.

• Hough, M. (2006). Final report of the school-based counselling project in Oban and Tobermory High Schools August 2005 - July 2006.

Glasgow: University of Strathclyde.

• Jackson, C., Pybis, J., Cooper, M., Hill, A., Cromarty, K., & Rogers, J. (2013). Users of secondary school-based counselling services and

specialist CAMHS in Wales: A comparison study. Counselling and Psychotherapy Research, 1-11. doi: 10.1080/14733145.2013.838596

• Killips, C., Cooper, M., Freire, E., & McGinnis, S. (2012). Motivation as a predictor of outcomes in school-based humanistic counselling.

Counselling and Psychotherapy Research, 12(2), 93-99. doi: 10.1080/14733145.2011.628030

• Lynass, R., Pykhtina, O., & Cooper, M. (2012). A thematic analysis of young people’s experience of counselling in five secondary schools across the UK. Counselling and Psychotherapy Research, 12(1), 53-62.

• McArthur, K., Cooper, M., & Berdondini, L. (2013). School-based humanistic counseling for psychological distress in young people: Pilot randomized controlled trial. Psychotherapy Research, 23(3), 355-365. doi: http://dx.doi.org/10.1080/10503307.2012.726750

• Pattison, S., Rowland, N., Cromarty, K., Richards, K., Jenkins, P. L., Cooper, M., . . . Couchman, A. (2007). Counselling in Schools: A Research Study into Services for Children and Young People in Wales. Lutterworth, Leicestershire: BACP.

• Pearce, P., Sewell, R., & Osman, S. (2013). The ALIGN project: A randomised controlled trial of school-based person-centred counselling. Paper presented at the BACP Research Conference 2013, Birmingham.

• Pybis, J., Cooper, M., Hill, A., Cromarty, K., Levensley, R., Murdoch, J., & Turner, N. (2014). Pilot randomised controlled trial of school-based humanistic counselling for psychological distress in young people: Outcomes and methodological reflections. Counselling and Psychotherapy Research. doi: 10.1080/14733145.2014.905614

• Pybis, J., Hill, A., Cooper, M., & Cromarty, K. (2012). A comparative analysis of the attitudes of key stakeholder groups to the Welsh Government's school-based counselling strategy. British Journal of Guidance & Counselling, 40(5), 485-498. doi:

10.1080/03069885.2012.718736

• Rupani, P., Haughey, N., & Cooper, M. (2012). The impact of school-based counselling on young people's capacity to study and learn.

British Journal of Guidance & Counselling, 40(5), 499-514. doi: 10.1080/03069885.2012.718733

• Twigg, E., Barkham, M., Bewick, B. M., Mulhern, B., Connell, J., & Cooper, M. (2009). The Young Person’s CORE: Development of a brief

outcome measure for young people. Counselling and Psychotherapy Research, 9(3), 160-168.

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