Impact of counselling services for children and young people

The research evidence generally suggests that school and community-based counselling services have a positive impact on the mental health and well-being of children and young people. This conclusion is tentative given that studies in the research literature with stronger research designs reported smaller positive impacts or no impact of counselling services and positive impacts were not consistently maintained when followed-up. Also, while data analysis indicated that counselling services were linked with improved psychological well-being scores following a counselling episode, we should approach these findings with caution:

• An association does not necessarily indicate that counselling caused these reductions in psychological distress, as other factors may have contributed to this,
• It was not possible to assess whether the improvement in pre-and post-counselling scores was large enough to be considered clinically real and meaningful,
• There may be differences in the way that local authorities use and collect YP-CORE scores that could affect the reliability of the data.

Notably no evidence emerged that indicated harmful impacts of counselling services.

Importantly, stakeholder experiences, including interviews with school staff, parents, and young people, were positive on the impact of counselling services despite recognition of the variation in service quality and hence effectiveness.

There was limited evidence to support a specific counselling approach or to understand the impact of counselling services for children and young people’s outcomes beyond mental health and wellbeing.

There is an increasing demand being placed on counselling services for children and young people and there are concerns from school leaders and practitioners about the sufficiency of available counselling provision to support this level of demand. Prior to the coronavirus (COVID-19) pandemic, while the use of counselling provision and onward referral rates to specialist CAMHS had remained relatively stable, a greater proportion of children and young people were engaging with counselling services for longer. However, since the pandemic there has been a marked increase in overall use of counselling services by children and young people, as well as those receiving multiple episodes of counselling.

Females have consistently used counselling services more than males, with a growing gender gap in recent years. A slightly higher percentage of females receive multiple counselling sessions and are referred to specialist CAMHS compared to males. This suggests a greater demand for counselling support among females.

It was also notable that anxiety was by far the most common presenting issue for children and young people and its prevalence has increased most years.