Abstract
AimsThe purpose of this study was to test the feasibility of a randomised controlled trial comparing six weeks of humanistic school-based counselling versus waiting list in the reduction of emotional distress in young people, and to obtain initial indications of efficacy.MethodsFollowing a screening procedure, young people (13 - 15 years old) who experienced emotional distress were randomised to either humanistic counselling or waiting list in this multi-site study. Outcomes were assessed using a range of self-report mental health measures, with the emotional symptoms subscale of the Strengths and Difficulties Questionnaire (SDQ) acting as the primary outcome indicator.ResultsRecruitment procedures were successful, with 32 young people consenting to participate in the trial and 27 completing endpoint measures. Trial procedures were acceptable to all involved in the research. No significant differences were found between the counselling and waiting list groups in reductions in levels of emotional symptoms (Hedges' g = 0.03), but clients allocated to counselling showed significantly greater improvement in prosocial behaviour (g = 0.89) with an average effect size (g) across the nine outcome measures of 0.25. Participants with higher levels of depressive symptoms showed significantly greater change.ConclusionThis study suggested that a randomised controlled trial of counselling in schools is acceptable and feasible, although initial indications of efficacy are mixed.Trial registrationCurrent Controlled Trials ISRCTN68290510.
Highlights
Levels of mental health problems in children and young people are increasing [1], with one in ten children in Britain experiencing a diagnosable mental health disorder [2].Within the UK, one of the responses to this growing problem has been the establishment of school-based counselling services [3]
Feasibility Over two school terms, 379 young people were screened for participation in the trial
This is approximately 47 young people per school per term, which was acceptable to the schools involved
Summary
Within the UK, one of the responses to this growing problem has been the establishment of school-based counselling services [3]. In. In terms of efficacy, the effect sizes observed in studies evaluating psychotherapeutic interventions versus no intervention with children and adolescents are around 0.70 [7,8]. Such evidence of efficacy primarily comes from trials of cognitive-behavioural therapies (CBT), and generally within a group format. Meta-analyses of person-centred approaches in child and adolescent psychotherapy have found effect sizes ranging from 0.15 to 0.93 [10]
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