Counselling is one of the most common psychological interventions delivered in schools where children can explore, understand and aim to overcome issues in their lives causing them difficulty, distress and/or confusion.It is viewed as an important, non-stigmatising strategy to help bring about improvements in mental health and wellbeing. Counselling helps children with personal, social and emotional issues affecting their wellbeing, attendance, learning and academic achievements, and relationships; and also develops skills to strengthen their resilience and deal with their problems and challenges.
What is counselling?
The British Association of Counselling and Psychotherapy (BACP) defines counselling and psychotherapy as ‘umbrella terms that cover a range of talking therapies’. It offers children the opportunity to express and explore how they feel and what they’re thinking with someone who is professionally trained, in order to bring about effective change and/or enhance their wellbeing.
However, younger primary school children may not yet have acquired the skills, language and understanding to fully engage in traditional talking therapies. For this reason, primary school counselling involves different ways of exploring experiences and expressing emotion beyond just talking. The most common counselling approaches used with primary school children involve:
- play therapy
- art therapy
- ‘psychoeducational approaches’ which help children and families understand their distress and how to deal with it in the best way
- use of storytelling.
This means that all counsellors working with children should have additional training and skills in creative approaches. Some therapists are specifically qualified as play, art, music or drama therapists.
Most counselling is conducted on a one-to-one basis which provides children with an opportunity to explore their difficulties in a welcoming and supportive environment, and to find their own ways of addressing their issues. Group counselling is also common in primary schools and family counselling may be appropriate in some instances. Some organisations that work in schools, such as Place2Be, also offer parent counselling in some schools.
Why offer counselling in schools?
There is a government commitment to improving children’s mental health with the expectation that, over time, all schools will make sure that pupils can access high-quality counselling services that can offer good outcomes. A 2016 NAHT/Place2Be survey of head teachers reported that 36% of primary schools in England have access to a school-based counsellor.
Given that children spend a large amount of their time in school it is an ideal environment in which to offer therapeutic support, ensuring that:
- The counselling provision forms part of a whole-school approach.
- School staff can discuss their concerns with an onsite mental health professional.
- Children can be referred to a counsellor onsite.
- Children learn how to ask for help when they need it.
- Children do not need to have a diagnosable mental health difficulty to access counselling in schools.
- Children and parents/carers will not have to attend an external agency or clinic (unless referred to a specialist service).
- Early intervention may help prevent escalation and the need to refer to specialist CAMHS (Child & Adolescent Mental Health Services).
- Counselling is often well integrated with other wider mental health support for children and families in the community.
Who benefits from counselling and how?
Research tells us that children are most likely to attend counselling because of:
- family problems
- trauma and abuse
- friendship difficulties or bullying-related trauma
Counselling helps a child develop coping skills and strategies to manage difficulty and change. It improves wellbeing and is a recommended early intervention for children in psychological distress or who have mild to moderate symptoms of depression.
On the whole, counselling is less effective for children with severe and persistent behavioural problems or hyperactivity. These children benefit most from family involvement in programmes such as Triple P, FAST and Incredible Years (see Challenging behaviours and Overactivity and poor concentration for more detailed information). However, drivers for some behavioural problems can be complex (e.g. attachment difficulties, trauma, prolonged experience of discrimination, bullying etc.). So if problems persist despite engagement with parenting support, then counselling or other outside specialist support may be necessary to help address and resolve potentially deeper-rooted, underlying difficulties.
Identifying children who may benefit from counselling
- Carry out an annual review of children’s mental health and wellbeing. Given that many child mental health problems and difficulties go under the radar, this (together with school staff’s observations) might provide a useful way to identify children who might benefit from help.
- Complete a Strengths and Difficulties Questionnaire which might help identify the severity and scale of problems and where difficulties lie.
- Ask the advice of a school-based counsellor if available.
Length of counselling
Children can attend counselling:
- for one session for brief advice and support
- for short-term counselling (e.g. around 6 weeks)
- for one to two terms, and
- as a longer-term intervention over a full academic year or more.
Some studies show that the more often children attend counselling, the greater the improvement. However, analysis of Place2Be data also suggests that most benefits for children take place at the midway stage (6 to 12 weeks) with generally decreasing improvements the longer time passes. This tells us that counselling is most effectively used, on average, as a short to medium term means of support for children facing difficulties.
What counselling services should schools consider?
Schools need to assess what type of counselling is best suited for their pupils. The decision on what type of counselling service to commission is often based on what is available locally, financial factors, the needs of children in the school, along with availability of suitably skilled staff, and space.
The DfE proposes several models of delivery for school-based counselling, including:
- Contracting individual counsellors (part or full-time) directly.
- Engaging with a local authority team of counsellors.
- Contracting with a third party, for example within the voluntary sector. These may be larger organisations devoted to school counselling and broader whole-school support or local community counselling services who work in schools.
- Paying for the time of a specialist children's mental health service (CAMHS) counsellor.
- Sharing funding of counselling services with other local schools and/or the local secondary school in a clustering approach to commissioning.
How can schools finance counselling services?
Many schools use their Pupil Premium funding, recognising that its purpose is to ‘raise the attainment of disadvantaged pupils of all abilities and to close the gaps between them and their peers’.
In some instances, local funding can be accessed to support the provision of counselling services in schools through involvement in transformation planning.
What does a good quality counselling service look like?
A good school-based counselling service should:
- Be well-known within the school and promoted to all staff, parents or carers and pupils.
- Have clear processes in place for referring a child to the service (teachers, school staff, parents/carers and self-referral).
- Be independent, yet integrated into the school.
- Appoint a member of school staff to act as liaison with the counsellor, who should ideally be part of a team dedicated to children needing additional support (including the SENCO, pastoral lead and DSL).
- Ideally have a dedicated counselling room that is accessible, private, secure, safe and welcoming.
- Have a clear accessible complaints procedure.
- Ensure that good arrangements are in place for working with, and referring onto, other specialist agencies.
Evaluating the effectiveness of counselling
The DfE’s counselling in schools publication reinforces the importance of collecting routine outcome data for children engaged with counselling to assess:
- the impact of the counselling on the child
- the effectiveness of the service overall and its value for money.
Ofsted also seeks evidence of the impact of interventions for pupils in need. It is critical to evaluate counselling services to ensure that the service is making a difference to children’s mental health in your school. Most counsellors will assess impact through using a good quality tool measuring where the child is before they access help and then reviewing progress with the child, family and teachers at set points to track progress.
Below are some of the ways in which counsellors might measure how their service impacts on children in the school and how they might assess the value of the service to the school:
- Anna Freud National Centre for Children and Families: measuring and monitoring children and young people’s mental wellbeing: a toolkit for schools and colleges.
- The CAMHS outcome research consortium (CORC): webpage of screening tools for measuring counselling and talking therapy outcomes and service experience. The age range that the tool is designed for and the strength of the evidence for the tool is also described for each recommended tool.
- MindEd is a free educational e-learning resource for professionals, on children and young people’s mental health. There is a comprehensive module on using outcome measures in counselling, including monitoring change.
Top tips for employing a counsellor
Read the DfE publication, ‘Counselling in schools: a blueprint for the future: departmental advice for school leaders and counsellors’.
Find out what counselling services are available locally, including agencies, charities and community-based organisations. You can also look at professional body websites for experts offering relevant services in your area, and ask colleagues at other primary and secondary schools what services they use and recommend.
Ensure the counsellor/s is suitably qualified (recommended minimum of a Diploma in Counselling) and is recognised on an accredited voluntary register and working within an ethical framework, such as BACP or equivalent.
In interview, check the following:
- their professional body and code of ethics/ethical framework
- previous experience of counselling children/working in school settings
- how the referral process for counselling works
- how they will work with children and parents/carers
- how they will integrate the service into the school
- how they will support teachers/staff seeking advice
- safeguarding training and knowledge
- how they will evaluate their service and report to the school on outcomes
- clinical supervision arrangements (essential for all counsellors)
- ongoing professional development.
Core competencies for counsellors working with children aged 4-11 years are currently under development by the British Association for Counselling and Psychotherapy (BACP). Once developed, these could form a key part of any job description and recruitment process for primary school counsellors.
Counselling professional bodies
Schools should ensure that any counsellor that they employ, or contract with, is a member of a professional body. Check on professional body websites for information and registers for qualified and accredited counsellors.
The following are some of the major professional associations, councils and societies (there are also smaller professional organisations):
- British Association for Counselling & Psychotherapy (BACP)
- UK Council for Psychotherapy (UKCP)
- National Counselling Society (NCS)
- British Association of Art Therapists (BAAT)
- British Association of Play Therapists (BAPT)
- Association of Child Psychotherapists (ACP)
- British Association for Music Therapy (BAMT)
- British Association of Drama Therapists (BADth)
- Independent Psychoanalytic Child & Adolescent Psychotherapy Association (IPCAPA)