School-based counselling in UK secondary schools: a review and critical evaluation

School-based counselling is one of the most prevalent forms of psychological therapy for young people in the UK, with approximately 70,000-90,000 cases per year. School-based counselling services in the UK generally offer one-to-one supportive therapy, with clients typically referred through their pastoral care teachers, and
attending for 3-6 sessions. Around two-thirds of young people attending schoolbased counselling services are experiencing psychological difficulties at ‘abnormal’ or
‘borderline’ levels; with problems that have often been present for a year or more. Clients are typically in the 13-15 year old age range, white, most commonly female; and presenting with family problems or, if boys, anger. With respect to effectiveness, non-directive supportive therapy is a NICE-recommended intervention for mild
depression; and there is emerging evidence to suggest that school-based humanistic counselling – a distillation of common school-based counselling practices in the UK – is effective at reducing psychological distress and helping young people achieve their personal goals. School-based counselling is evaluated positively by service users and school staff; and is perceived by them as an effective means of bringing about improvements in students’ mental health and emotional wellbeing. School staff and service users also perceive school-based counselling as enhancing young people’s capacity to engage with studying and learning. From the standpoint of a contemporary mental health agenda, the key strengths of school-based counselling are that it is perceived as a highly accessible service; and that it increases the extent to which all young people have an independent, supportive professional to talk to about difficulties in their lives. However, there are also several areas for development: increasing the extent to which practice is evidence-informed, greater use of outcome monitoring, ensuring equity of access to young people from black and minority ethnic backgrounds, increasing service user involvement, and enhancing levels of integration with other mental health provisions. It is hoped that current initiatives in the development of competences, e-learning resources and accreditation for counsellors working with young people will help to achieve this. The conclusions of the review are that commissioners should give consideration to the utility of school-based mental health provisions; and that school-based counsellors – working with colleagues in the field of child and adolescent mental health – have the potential to contribute to an increasingly comprehensive, integrated and ‘young person-centred’ system of mental health care.