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New research paper: Longer-term effects of school-based counselling in UK primary schools

New research paper: Longer-term effects of school-based counselling in UK primary schools

Jemma White

Jemma White

Evaluation Manager - Jemma joined Place2Be in 2004 and works to evaluate the impact of our services. She is interested in child development and mental health, and recently completed a Level 2 Child Counselling course to enhance our research outcomes, and better enable us to achieve evidence-based practice and practice-based evidence.

Jemma White, Place2Be's Evaluation Manager, shares the findings of our new study with the University of Exeter and University of Cambridge.

“Primary school children have long-term mental health benefit from counselling in school”

Place2Be has strong and compelling evidence over time that counselling children and young people in primary schools is effective in reducing children’s mental health difficulties. This evidence was gathered by Place2Be’s mental health professionals through the Strengths and Difficulties Questionnaire (SDQ; Goodman, 2001) before and after counselling. This was first indicated in the Lee and colleagues’ paper (2009) and in Place2Be’s commitment to routine annual evaluation.

In recent years, there has been a growing recognition of the importance of supporting children’s mental health and the increasing need for school-based counselling. An estimated 60-70% of schools in England are now offering some form of mental health provision to pupils (mostly secondary provision). However, until this study, the lasting impact of early intervention counselling services, such as Place2Be’s, on the mental health of children and young people was relatively uncertain.

A previous economic evaluation on behalf of Place2Be demonstrated that Place2Be’s counselling intervention also has long-term economic benefits, resulting from higher employment output and lower spending on public services, amounting to over £5,700 per child (Pro-bono Economics, 2018). However, this figure was based on a 50% reduction of the estimated benefits applied by the researchers due to the lack of evidence available on the counterfactual and the potential fading out of the initial mental health improvements after counselling, over time.

Place2Be has built on our own research and independently addressed this question in the current study, published in the European Child & Adolescent Psychiatry Journal, through the analysis of SDQ data on 740 children, who took up and completed one-to-one counselling between February and July 2016. SDQs were completed by teachers and parents before the counselling started, after the counselling course finished, and approximately one year after the end of counselling, between February and July 2017.

This research found that children’s mental health improved according to both teachers and parents following counselling and these improvements were maintained one year later. The research further benefitted from including a matched comparison group taken from the British Child and Adolescent Mental Health Survey (BCAMHS) dataset. The analysis, which predicted parent-rated SDQ trajectories over a 2-year period, presents persuasive findings that mental health improvement in Place2Be’s children was not only greater, but was also estimated to be further sustained over 2 years when compared to the independent BCAMHS sample group.

This is unique and innovative research that sets Place2Be’s evidence base apart in terms of long-term outcomes of counselling children, compared to short-term evidence of efficacy that in itself is lacking for the primary age cohort. Therefore, it is really important that Place2Be could provide the evidence that counselling is associated with improved mental health and that this association is long-lasting. This has implications for the long-term cost-benefit projections of children’s mental health services and the paper highlights the value of revisiting the cost-benefit analysis adjusting the 50% reduction of benefits in light of our new research.

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