Summary of the impact

Research at Strathclyde has led to a significant increase in the delivery of school-based counselling in the UK, with services established in all secondary schools in Northern Ireland and Wales since 2007 and 2008, respectively. It is estimated that there are approximately 70-90,000 service users per year across UK secondary schools. School-based counselling significantly reduces young people's psychological distress, and helps them gain self-confidence, achieve their goals, and concentrate more in class. Strathclyde's research has led the way in demonstrating the effectiveness of this type of intervention, and has played a pivotal role in supporting its roll-out and development, thereby improving the well-being of large numbers of young people across the UK.

Underpinning research

Context

School-based counselling has been defined by the British Association for Counselling and Psychotherapy (BACP) as `a professional activity delivered by qualified practitioners in schools. Counsellors offer troubled and/or distressed children and young people an opportunity to talk about their difficulties, within a relationship of agreed confidentiality.' School-based counselling services have existed in the UK since the 1960s, but their dissemination has been sporadic, and by the 1990s they had almost disappeared. However, the last two decades have seen a significant revival in the delivery of school-based counselling in the UK; and a major factor supporting this has been the existence of empirical evidence demonstrating its association with improvements in wellbeing. From 2003 to the present day, Professor Cooper and colleagues at the Counselling Unit, University of Strathclyde have been at the forefront of this research.

Key findings

In 2004, Professor Cooper published an in-depth, mixed-method evaluation of a school-based counselling service delivered in three Glasgow secondary schools [1]. This was the first rigorous evaluation of its kind, and demonstrated that school-based counselling was associated with a significant and large reduction in psychological distress. This report also identified that a high proportion of young people were either `satisfied' or `very satisfied' with their counselling; that they found counselling beneficial because they could talk and be listened to and get things off their chest; and that guidance/pastoral care teachers also rated the counselling service as helpful to the young people involved. A follow-up study of school teachers' attitudes replicated and extended this latter finding; with subsequent research indicating that school-based counselling also helped young people engage with studying and learning.

In 2009, Professor Cooper published the first comprehensive review of evidence from audit and evaluation studies of school-based counselling in the UK [2]. Through meta-analytic techniques, it was 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.

Further cohort studies, including an evaluation of 3,613 cases of school-based counselling across Wales [3], demonstrated conclusively that the intervention was associated with significant positive benefits.

From 2008 onwards, Professor Cooper and colleagues have begun to test - and demonstrate - the effectiveness of school-based humanistic counselling through randomised controlled trials (RCTs), publishing in international peer reviewed psychotherapy and mental health journals [4,5]. Data from the most recent meta-analysis suggests that the average effect size for school-based counselling over a 12-week period, compared against a waiting list condition, is 0.82 for reduction in psychological distress, 0.40 for reduction in psychological difficulties, 0.45 for increase in self- esteem, and 0.64 for achievement of personal goals. Meta-analytical findings also indicate that school-based counselling is associated with reductions in clinical levels of distress for approximately 45% of young people using these services.

Most recently, studies have focused on the processes by which school-based counselling may bring about positive benefit and the methods by which this benefit could be enhanced: in particular, through the integration of systematic feedback from clients on the outcomes and process of therapy [6].

Key researchers at the University of Strathclyde

All research has been led by Mick Cooper, Senior Lecturer in Counselling (2003-5), Reader in Counselling (2005), Professor of Counselling (2005-present). Lucia Berdondini (Lecturer in Counselling until 2008), Mike Hough (Senior Lecturer in Counselling, retired 2005), Lorna Carrick (Lecturer in Counselling) and Elizabeth Freire (Lecturer in Counselling Psychology, left in 2011) have been involved in data collection and analysis.

Since 2008, collaborations have primarily been with the British Association for Counselling and Psychotherapy (BACP); with the charities Barnardo's, Relate, and Place2Be; and with the Universities of Newcastle (Dr Susan Pattison) and Newport (Dr Sheila Spong).

References to the research

Outputs 3-6 are submitted to REF2 in UoA 25.

Other evidence for quality of research. Reference 1 received the BACP Recognised Achievement in Counselling and Psychotherapy Research award in the Established Researcher category. References 2-6 were published in peer reviewed international journals. Reference 2 is the second most highly cited paper for its journal.

Details of the impact

Process from research to impact.

Research demonstrating the effectiveness and acceptability of school-based counselling was presented at the Scottish Parliament Health and Sports Committee (2009); to Paul Burstow (former Minister of State for Care Services) (2012); and at the Stormont parliament in Northern Ireland (2012). It was also presented at a wide range of national conferences, including the Psychological Therapies in the NHS conference (2012). The research was more widely disseminated to policy- makers and stakeholders through published reports that were made widely available online, through peer-reviewed journal papers, and through articles in professional journals. Professor Cooper collaborated with Dr Susan Pattison at the University of Newcastle, who led on a 2007 report on school-based counselling in Wales, and was a co-investigator on the 2010 RCT (reference 4). He also collaborated with Dr Sheila Spong at the University of Newport, who undertook the case study component of a 2012 evaluation of school-based counselling in Wales.

Types of impact
Impact on policy makers, investment and services

Research reports demonstrating the effectiveness and acceptability of school-based counselling were drawn on by policy makers in Northern Ireland as support for the establishment of school- based counselling services, which are now in existence across all secondary schools. The National Co-ordinator for the Northern Ireland Department of Education Independent Counselling Service (Source 1) for Schools stated: "The Research carried out by Strathclyde University has greatly influenced and enhanced the manner in which the Independent Counselling Service for Schools is delivered in every Post Primary School across the country. Having such a strong research base from Strathclyde which shows the effectiveness of school based counselling has given added confidence that the service delivered in our schools is not only fit for purpose, but always focuses on the paramountcy of the child or young person's welfare."

The 2007 research report into services for children and young people in Wales set ten recommendations that were wholly adopted by the Welsh government, and became the basis for the provision and delivery of the Welsh government's £6.5M school-based counselling strategy in 2008. The subsequent 2011 evaluation of this Strategy, co-led by the University of Strathclyde, supported the £14.25M extension of the Strategy and its subsequent establishment of school- based counselling as a constitutional responsibility for local authorities under The School Standards and Organisation (Wales) Bill (2013). The co-ordinator for School-based Counselling in Wales at the time of the research, stated in a presentation at the British Association for Counselling and Psychotherapy (BACP) Research Conference (May 2013), "the evaluation was hugely influential.... I don't think the additional money or the statutory implementation would have happened without that hard evidence" (Source 2).

By demonstrating the effectiveness of school-based counselling, the research has also played an important role in the UK Coalition Government's decision in 2012 to allocate approximately £750k to the development of e-learning resources for counsellors working with children and young people (`Counselling MindEd', for which Professor Cooper acts as Clinical Lead, Source 3), and the associated appointment of a National Advisor for Counselling for Children and Young People (Professor Cooper). The Chair of the BACP (Source 4), states: "Research from the University of Strathclyde on the effectiveness of school-based counselling was presented at a face-to-face meeting with Paul Burstow, former Minister of State for Care Services, and played a significant role in the subsequent allocation of approximately £750k to the development of e-training for counsellors working with children and young people."

This evidence base has also formed the basis for the development, in 2012-13, of UK-wide competences for counselling children and young people by the BACP (co-chaired by Professor Cooper). The Head of Research at BACP (Source 5) said "RCT research from the University of Strathclyde on the effectiveness of school-based counselling provided a key source in determining the nature of the competences established for counsellors working in the children and young people's field."

The evidence-based competences developed for counselling children and young people and the Counselling MindEd e-learning programme will form the basis for training and accreditation of all counsellors working with children and young people in the UK — approximately 4,000 therapists — with the intention that this will significantly improve the effectiveness of their work. Research demonstrating the effectiveness of systematic feedback in school-based counselling has influenced the UK's largest provider of counselling in the primary school sector, Place2Be, to trial the use of this system from 2012. The Research and Evaluation Manager for Place2Be (Source 6) confirms that "research conducted at the University of Strathclyde on the value of using systematic feedback in counselling with primary school children has encouraged us to pilot this system within 9 of our schools. The data from this pilot is currently being evaluated and will inform our future service delivery decisions'. Professor Cooper has also promoted this systematic feedback work through articles and conference presentations to a professional audience".

Impact on health and welfare of children and young people in the UK

Today, school-based counselling is primarily delivered to young people in the 11-18 year old age range; although there is also some provision to children in primary schools. In this respect, the research which has supported the enhancement of both the quantity and quality of school-based counselling provision in the UK had made a significant contribution to the health and welfare of young people and children in the UK. Between 2008 and 2013, approximately 400,000 young people will have received school-based counselling across the UK (Source 7). The intervention is normally delivered to pupils who experience psychological difficulties — most commonly family problems, anger issues (particularly males), bereavement and relationship problems — though it is normally made accessible to any young person who expresses a wish to participate in it. Approximately 60% of service users are female; and there is a mix of ethnicities. In Wales and Northern Ireland, school-based counselling is delivered in all publicly-funded secondary schools; and in approximately 70% of schools in England and Scotland. There is also delivery of school- based counselling in the independent and special needs sectors in the UK (Source 7).

Based on predicted recovery rates, approximately 180,000 of those young people who attended school-based counselling between 2008 and 2013 will have moved from clinical levels of psychological distress to non-clinical levels; though 40,000 will also have moved from non-clinical levels to clinical levels (Source 7). The meta-analyses of RCT data also indicates that, on average, school-based counselling brings about a reduction in psychological distress of 0.82 standard deviations, and a 0.64 standard deviation increase in attainment of personal goals. Qualitative reports from teachers and service users also suggest that approximately 80% of young people who participate in school-based counselling (approximately 320,000 young people in the UK between 2008 and 2013) will experience improvements in their capacities to engage with studying and learning, particularly in terms of being able to concentrate more in class (Source 7).

The Senior Lead Advisor for Counselling Children and Young People for the BACP stated (Source 8): "School-based counselling now reaches hundreds of thousands of young people and children in the UK, and is leading to measurable improvements in their wellbeing. Research at the University of Strathclyde has been highly influential in supporting the establishment and dissemination of these services, and in these respects contributing to the enhanced wellbeing of many young people in the UK."

Sources to corroborate the impact

1. Statement from the National Co-ordinator for the Northern Ireland Department of Education Independent Counselling Service for Schools
2. Jones, S. (2013) `School-based counselling in Wales from strategy to entitlement', 19^th Annual British Association for Counselling and Psychotherapy Research Conference, Birmingham.
3. http://counsellingminded.com/staff-biographies/ Prof Cooper's role in Counselling MindEd
4. Statement from the Chair of the British Association for Counselling and Psychotherapy
5. Statement from the Head of Research at the British Association for Counselling and Psychotherapy.
6. Statement from Research and Evaluation Manager, Place2Be.
7. Cooper, M. (2013). School-based counselling in UK secondary schools: A review and critical evaluation. Lutterworth: BACP/Counselling MindEd. http://counsellingminded.com/wp-content/uploads/2013/07/cooper_MindEd_report.pdf
8. Statement from Senior Lead Advisor for Counselling Children and Young People, BACP