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School counselling can help young people manage mental health issues despite costs, first-ever research into the subject reveals

For the first time in the UK, a large-scale study has revealed that school-based humanistic counselling** is effective and should be considered as a viable treatment option for children suffering from mental health issues despite considerable costs.

The collaborative research team for this important study included Dr Peter Pearce, Metanoia Faculty Head. Peter was the Clinical Lead, with Professor Mick Cooper from University of Roehampton as Principal Researcher. The study was conducted between 2016 and 2018 across 18 London schools and surveyed 329 children aged between 13 and 16 years olds at six-week intervals. It found that school-based humanistic counselling led to significant reductions in pupils’ psychological distress over the long-term, compared to pupils who only received pastoral care. However, it was also revealed that this type of counselling comes at a cost, totalling between £300 and £400 per pupil.

‘Clinical Lead for the study, Metanoia’s Dr. Peter Pearce said, “In England, approximately one in seven young people meet criteria for a mental health problem with prevalence rates rising over the past two decades and the current pandemic likely to add to this challenge. Schools, represent an excellent place to try to address these issues, giving young people unparalleled swift access and overcoming potential barriers such as time, location, and cost. This important study provides the first reliable evidence that school-based humanistic counselling is effective and should be considered as a viable treatment option for young people with mental health issues despite additional costs.”

With one in eight 5 to 19 year olds in the UK estimated to meet the criteria for a mental health disorder***, the research provides critical evidence for schools considering expansion of their mental health services.

The study found that pupils who were offered counselling services experienced significantly improved self-esteem, as well as large increases in their achievement of personal goals. The paper also calls for urgent evaluation of other mental health interventions for adolescents, such as Cognitive Behavioural Therapy (CBT) and classroom modules on emotional literacy.

The project lays important groundwork for further studies and explorations into the improvement of mental health provision for school children in the UK and costs, particularly with the ongoing impact that Covid-19 is having on young people’s mental health issues across the country.

Lead author of the paper, Mick Cooper, Professor of Counselling Psychology at the University of Roehampton, said: “Adolescence is a period of rapid change for young people and makes them particularly vulnerable to mental health problems, so studies like ours, which is the first large scale project of its type ever to be conducted in the UK, are vital to assess how mental health services can be improved in schools.

“Our analysis found that school-based humanistic counselling works and makes a difference to the well-being of pupils, albeit at a cost. However, it also highlighted the importance to continue to study the provision of mental health support in schools and how other services, such as CBT, can be employed to tackle these issues. There is pressing need for a diverse and comprehensive mental health provision and care for young people in schools across the UK, but it is essential that this is properly assessed to establish what works and what should be widely implemented to improve the mental well-being of young generations.”

Jo Holmes, Children, Young People and Families Lead at the British Association for Counselling and Psychotherapy (BACP) said: “Professionally delivered school counselling services are not cheap, and neither should they be. School counsellors are highly trained,

experienced and skilled practitioners, often working with complex need and trauma linked to psychological distress. School counselling has the potential to take some of the short and long-term pressure off statutory provision, and can support young people as they transition to and from more specialist mental health services”.

“Counselling provides a safe space where young people can truly explore what is worrying them, setting their own goals, tailored to meet their individual needs, and helping them to ‘off-load’ and function better in their daily lives. It delves deeply into complex thoughts, feelings and emotions and is not a short-term sticking plaster.”

The ‘Effectiveness and Cost-effectiveness Trial of Humanistic Counselling in Schools (ETHOS)’ study was carried out as a collaboration between the University of Roehampton, the London School of Economics (LSE), Manchester University, the University of Sheffield, the University of Kent and Metanoia Institute, as well as the British Association for Counselling and Psychotherapy (BACP), and the National Children’s Bureau (NCB). The work was supported by the Economic and Social Research Council [grant reference ES/M011933/1]; with additional funding to support the team from the University of Roehampton, the BACP, and the Metanoia Institute.

The full study can be accessed here. Further information on the study is available on https://www.roehampton.ac.uk/research-centres/centre-for-research-in-social-and-psychological-transformation/ethos/

*The Lancet Child & Adolescent Health [https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30363-1/fulltext]

** School-based humanistic counselling consists of one-on-one sessions with a counsellor employed by a school, and is based on a child-centred approach, with children talking about their issues and developing solutions with the aid of the counsellor, rather than therapist-led approaches, such as CBT. *** https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2017/2017

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  • 01 January 0001