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School Based Humanistic Counselling (SBHC)

Theory of Change

School Based Humanistic Counselling (SBHC) is founded on person-centred assumptions, supported by social psychology research. A basic premise is that young people can experience higher levels of psychological distress when they are estranged from their lived experiences, needs and wants. SBHC therefore applies a person-centred approach to help young people understand and appreciate themselves and their experiences. This enables them to become more attuned with their authentic feelings, wants and needs, and enhances their capacity to identify, manage, and overcome distresses arising from challenging situations.

Priorities

School Based Humanistic Counselling (SBHC) aims to help young people experiencing psychological distress to effectively address their difficulties. This is achieved by use of person-centred approach to enhance participants’ capacity to identify, manage, and overcome distresses arising from challenging situations.

Core Components

This individualised intervention is centred on the theory that young people going through distress are capable of effectively addressing their difficulties if they can discuss them with a supportive and sympathetic counsellor. SBHC therefore applies a person-centred approach to help young people understand and appreciate themselves and their experiences. This enables them to become more attuned with their authentic feelings, wants and needs, and enhances their capacity to identify, manage, and overcome distress arising from challenging situations. 

SBHC is delivered by qualified counsellorsand recognises that individual young people will not only present differing levels of problem severity, but also have varying levels of personal capacity and social resources available to them. Hence the number of sessions needed to achieve their therapeutic goals will vary accordingly. To encompass this variation, it is recommended that after an initial ten sessions, the necessity of any booster sessions (as follow up) is tailored to the needs of the individual client. During counselling sessions, counsellors help the young people access and express their feelings and needs; help them reflect on their experiences and behaviour; and encourage them to consider the varying options they face, and then decide on the most helpful choices for their particular circumstances. Techniques applied include active listening, emphatic reflections, and consistent use of unconditional positive regard.

A clinical practice manual developed for the Effectiveness and Cost-effectiveness Trial of Humanistic Counselling in Schools [ETHOS] can be used to support programme delivery. Participants can be referred to receive SBHC via referral from a member of school staff (typically pastoral care teacher), self-referral, or referral by parents/carer or friend. Parental consent to receive this intervention is not typically required except in situations where the young person is assessed as lacking capacity to give consent.

School Based Humanistic Counselling (SBHC) is a flexible intervention, so the length of sessions and style of intervention can vary according to the young persons’ needs and goals.

SBHC can be delivered remotely through online platforms.

https://earlyinterventionframework.nhs.scot/programmes/school-based-humanistic-counselling/

 

Evidence Base for SBHC

The best evidence for SBHC in children aged 13-18 years comes from two internally conducted Randomised Controlled Trial (RCT) (Cooper et al., 2021; Pearce et al., 2017) and one internally conducted pre-post single group longitudinal study (Cooper et al., 2014).

The first RCT (Pearce et al., 2017) included 64 students aged 11-18 years from three urban secondary schools in London. The single group study included 256 students aged 11-17 years from 11 secondary schools in Scotland. Outcomes, for children in the 13-18 age range, for these two studies are the same as is detailed in the 6-12 age range above.

The second RCT (Cooper et al., 2021) included 329 young people aged 13-16 years with at least moderate levels of emotional symptoms. Participants were recruited from eighteen state funded secondary schools in London, ten located in the deprived areas, with an average of 32% of participants receiving free school meals. Compared to participants who did not receive the SBHC, the following outcomes were observed:

Outcomes Achieved

Child Outcomes

  • Significantly reduced psychological distress at 12 weeks and 24 weeks post-baseline
  • Significantly improved goal attainment and self-esteem at 6 weeks, 12 week, and 24 weeks post-baseline
  • Significantly improved mental wellbeing at 12 weeks post-baseline
  • Significantly reduced psychological difficulties at 12 weeks post-baseline

 

Key references

 

  1. Cooper, M., Stafford, M. R., Saxon, D., Beecham, J., Bonin, E.-M., Barkham, M., Bower, P., Cromarty, K., Duncan, C., Pearce, P., Rameswari, T., & Ryan, G. (2021) Humanistic counselling plus pastoral care as usual versus pastoral care as usual for the treatment of psychological distress in adolescents in UK state schools (ETHOS): a randomised controlled trial. Lancet Child and Adolescent Health. https://doi.org/10.1016/S2352-4642(20)30363-1
  2. Pearce, P., Sewell, S., Cooper, M., Osman, S., Fugard., A.J.B., & Pybis, J. (2017) Psychology and Psychotherapy: Theory, Research and Practice, 90,138-155 https://pubmed.ncbi.nlm.nih.gov/27470500/