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Training and accreditation standards play a critical role in the development of a research‐informed agenda. This commentary on Barkham et al. (Counselling and Psychotherapy Research, 2024) discusses obstacles to fully integrating research into the training and standard agendas, and the potential role that the British Association for Counselling and Psychotherapy (BACP) can play in helping to overcome such obstacles. Knowledge of research evidence is currently limited in training and accreditation standards for counselling and psychotherapy, and course tutors are often not familiar—or engaged—with research findings. In the development of professional standards (for instance, within SCoPEd), the BACP should work to ensure that research competencies are comprehensive, contemporary and explained in a granular manner. Further helpful developments might include an annual research‐oriented conference for trainers and clinical supervisors, a journal dedicated to disseminating research and good practice in training and clinical supervision and/or a training/clinical supervision research network to coordinate activities in these area. BACP events—across all elements of the profession—should strive to address issues of research awareness and participation, and the use of research to inform practice. Critically, across all of these possibilities, BACP's Research Department, alone, cannot be left to support moves to a research‐informed profession. Rather, an organisation‐wide initiative is needed in which appreciation of the research evidence is at the heart of all aspects of the Association's work. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to capture the most salient aspects of first‐session activities by a therapist who consistently had good clinical outcomes. Method: Constructivist grounded theory was used to analyse the first three audio‐recorded psychotherapy sessions with two clients. Results: The analysis generated 12 categories organised into three major domains: (a) promoting clients' sense of agency and the collaborative nature of the therapeutic process; (b) supporting clients' exploration of meaningful contents, balancing responsively between following clients and introducing new dimensions; and (c) creating a climate of emotional security based on empathic presence, authenticity and positive regard. Conclusions: The results show key aspects of the therapist's performance, such as distinguished clinical skills, responsiveness and strong relational abilities. The results support the literature on highly effective therapists. They also contribute to practice and psychotherapist training. Domains and categories from this study may be the basis for a checklist of some essential features to be included in psychotherapists' deliberated practice programmes. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present research was to test the feasibility of a randomised controlled trial comparing five consecutive days of regular online jigsaw puzzling (JP) against a no‐treatment control group in improving mental well‐being outcomes in older adults. Methods: Eighteen older adults (65–80 years) were randomly assigned to either the JP (9) or control (9) group and completed a range of mental health and well‐being measures for five consecutive days. We assessed recruitment rates, completion rates and participants' experiences of the intervention. Results: Recruitment issues meant that 18 of the 32 intended participants took part in the trial. All participants completed the trial. Qualitative analysis indicated that participants experienced the JP intervention as accepted, with indications of enhanced enjoyment and self‐esteem at study completion. Conclusion: The present pilot study indicates that testing the efficacy of JP is feasible. A full‐scale clinical trial of this intervention should be considered, which can determine the efficacy of the JP intervention. [ABSTRACT FROM AUTHOR]

Introduction: Dissatisfied dropout costs services financially and impacts client well‐being. Research is limited on reasons for dissatisfied dropout in adolescents. Preliminary research suggests it may be due to feeling uncomfortable with silences, not knowing what to talk about, or unresolved ruptures. This study aimed to understand and refine the theory about the reasons for adolescent dissatisfied dropout from school‐based humanistic counselling (SBHC). Method: A theory‐building series of case studies was conducted with three dissatisfied dropout adolescent cases who received SBHC during a randomised controlled trial. Gaps in the theory were established by exploring the themes in one case. Testing and developing the theory with additional cases involved comparing themes and theory statements to case data. The final theory integrated data across the three cases. Results: Therapeutic relationship difficulties and client factors were the principal, overlapping reasons for dissatisfied dropout. Relationship difficulties included a poor therapeutic alliance, the counsellor persisting with their own agenda, repetitive client/counsellor interactions with silences, the client not feeling able to trust the counsellor with a risk issue and a lack of knowledge about humanistic counselling. Client factors included the client's hesitancy and ambivalence to talk about their feelings in the counselling. Conclusion: The results fitted with, but elaborated on and extended, the theory that a poor alliance, silences and misconceptions about counselling may lead to dissatisfied dropout. Emerging findings suggest the client's negative perception about disclosing their feelings and a lack of metacommunication about any difficulties in the therapeutic relationship may lead to dissatisfied dropout from SBHC. [ABSTRACT FROM AUTHOR]

Mental health and well‐being outcomes in psychotherapy and counselling have largely been studied through the use of standardised nomothetic measurement. A key limitation is that nomothetic measurement and current statistical analyses do not necessarily capture the outcomes of the complicated and individual psychotherapy processes. There is an increased interest in the use of idiographic patient‐reported outcome measures (I‐PROMs), which are uniquely useful because they may explore areas of importance that are unexplored by nomothetic outcome measures. We argue that to optimise the value of I‐PROMs, it is necessary to consider their contribution alongside standardised nomothetic measures. However, there are important considerations with respect to whether or not I‐PROMs from different clients, or indeed from the same client, can be meaningfully explored at a team/service level, and alongside standardised nomothetic outcomes. We provide worked examples on real client data to show that delineating four quadrants of analysis is important to explore the breadth of information: (a) individual progress on single items, (b) individual progress by aggregated scores, (c) team/service‐level progress by goal item/theme and (d) team/service‐level progress by aggregated scores. [ABSTRACT FROM AUTHOR]

Background: The Relational Depth Frequency Scale (RDFS) assesses moments of profound connection in psychotherapy, associated with therapeutic benefit. To date, the RDFS has not been tested for its retest reliability, divergent and criterion validity, and measurement invariance, nor has it been tested in stratified samples of psychotherapy patients. Methods: Two stratified online samples of United Kingdom (n = 514) and United States (n = 402) psychotherapy patients filled out the RDFS, the Brief Social Desirability Scale (BSDS); and the Satisfaction with Therapy and Therapist Scale‐revised (STTS‐R). Two subsamples of patients (United Kingdom: n = 50 and United States: n = 203) filled out the RDFS again after 1 month. Results: Reliability for the six‐item RDFS were excellent in United Kingdom and United States samples (Cronbach's α = 0.91 and 0.92; retest r = 0.73 and r = 0.76). Divergent (r = 0.10 and r = 0.12) and criterion validity (r = 0.69; and r = 0.70) were good. Full scalar invariance was established across countries, genders, and time. Conclusion: This contributes important evidence to the validity of the RDFS. Future research should assess predictive validity against psychotherapy outcomes and replicate these analyses in diverse samples. [ABSTRACT FROM AUTHOR]

The present study aimed to test the reliability and validity of the Person Centred and Experiential Psychotherapy Scale–Young Person version (PCEPS‐YP). This is a newly developed and adapted 9‐item scale which aims to measure counsellor competences in, and adherence to, person‐centred practice, when working with adolescents. Counselling practice was assessed for 19 counsellors by randomly selecting 20‐min audio segments from 142 recorded counselling sessions. Audio material was independently rated by eight raters using the PCEPS‐YP to produce an average adherence rating per counsellor. Scale reliability was assessed via interrater reliability and internal consistency testing. Convergent validity was tested using ratings from the observer‐rated Barrett‐Leonard Relationship Inventory (BLRI Obs 40), and the scale was subjected to exploratory factor analysis. Results showed a high degree of internal consistency within raters (α = 0.95), marginally acceptable reliability across grouped raters (α = 0.58) and weaker reliability between pairs of raters (α = 0.50). Exploratory factor analysis revealed one strong factor for the scale with no subscales. Small‐to‐moderate correlations existed between the PCEPS‐YP and the BLRI subscales and mean total score (rs =.12 to.40). Our findings suggest that the PCEPS‐YP has potential as an effective, reliable and valid tool for assessing competence and adherence in person‐centred practice with young people, both for research and for clinical purposes. However, training procedures need to be established that can enhance interrater reliability, and more evidence of convergent validity is needed. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to pilot a randomised controlled trial that aimed to test the hypothesis that counselling utilising a pluralistic framework was more effective than counselling as usual for young people experiencing issues as a result of their addiction. Method: Sixty‐four clients presenting with issues of addiction were allocated to either a counselling‐as‐usual (n = 33) or a pluralistic (n = 31) intervention. Psychometric measures (YP‐CORE and SDQ) were taken at baseline, endpoint and 3‐month follow‐up to compare changes in levels of psychological distress. Results: The use of a randomised controlled trial in practice‐based research was found to be feasible to both clients and the organisation in which the study took place. Recruitment and retention rates were acceptable. No statistically significant differences between groups were found on the primary measure. Discussion: The findings highlight the feasibility and acceptability of conducting such research within this unique context. The findings give preliminary evidence of the effectiveness of both counselling interventions. The absence of significant differences on our primary outcome between the two arms in this trial is not unexpected given its lack of power. Further research should continue to develop protocols to further maximise client retention and counsellor adherence. [ABSTRACT FROM AUTHOR]

Objective(s): To examine the psychometric properties of the idiographic Goal‐Based Outcome (GBO) tool for young people: test–retest stability, convergent validity, and sensitivity to an intervention. Methods: This measure validation study used data from a randomized controlled trial of school‐based humanistic counseling. We used multilevel analyses to assess test–retest stability, convergent validity of the GBO tool against nomothetic measures of mental wellbeing, and sensitivity to an intervention. Results: The GBO tool showed acceptable stability over a 6–24 week period; moderate convergent validity with nomothetic measures of mental well‐being, self‐esteem, and depression; and greater sensitivity to an intervention than a measure of psychological distress. Conclusions: The GBO tool shows evidence of having acceptable psychometric properties and is suitable for monitoring change on individual goals. It may also have the capacity to function as a population‐level indicator of outcomes in conjunction with the use of other measures of mental health and wellbeing. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the reliability, validity, and clinical utility of an idiographic, goal‐focused patient‐reported outcome measure: The Goals Form. Methods: Data were analyzed from 88 participants, across three samples, who had participated in collaborative–integrative psychotherapy at university‐based clinics in the UK. The samples were approximately 70% female with mean age of 30 years old. Results: The psychometric properties of the Goals Form were generally good. Noncompletion of individual items was low, temporal stability tended to be at target levels, and mean change scores showed moderate to good convergent validity against measures of psychological distress. The measure appeared sensitive to change in psychotherapy and was experienced by most patients as helpful. Conclusions: The Goals Form shows acceptable psychometric and clinical properties for routine outcome monitoring in psychotherapy. [ABSTRACT FROM AUTHOR]

Idiographic patient‐reported outcome measures (I‐PROMs) are a growing set of individualized tools for use in routine outcome monitoring (ROM) in psychological therapies. This paper presents a position statement on their conceptualization, use, and analysis, based on contemporary evidence and clinical practice. Four problem‐based, and seven goal‐based, I‐PROMs, with some evidence of psychometric evaluation and use in psychotherapy, were identified. I‐PROMs may be particularly valuable to the evaluation of psychological therapies because of their clinical utility and their alignment with a patient‐centered approach. However, there are several challenges for I‐PROMs: how to generate items in a robust manner, their measurement model, methods for establishing their reliability and validity, and the meaning of an aggregated I‐PROM score. Based on the current state of the literature, we recommend that I‐PROMs are used to complement nomothetic measures. Research recommendations are also made regarding the most appropriate methods for analyzing I‐PROM data. [ABSTRACT FROM AUTHOR]

Background: obsessive‐compulsive disorder (OCD) is a chronic, debilitating psychological condition. To date, there has been no published research exploring brief humanistic counselling as an intervention for OCD. This study presents a case study of an adolescent client with obsessive‐compulsive difficulties ('Sunil') receiving school‐based humanistic counselling. Aims: (a) To test humanistic counselling for an adolescent client experiencing obsessive‐compulsive difficulties; (b) to help improve brief humanistic counselling in its approach to working with adolescent clients experiencing obsessive‐compulsive difficulties. Method: This research used a mixed methods theory‐building case study, based on a rich case record. Results: The brief counselling did not reduce Sunil's obsessive‐compulsive difficulties. The core conditions were delivered in sessions, and the counselling allowed for the client to share traumatic memories and build peer relationships. However, the counselling did not seem to be directive at targeting Sunil's obsessive‐compulsive difficulties, and the silence in sessions was experienced by the client as awkward. Implications: Further research should be conducted investigating the therapeutic and problematic aspects of brief humanistic counselling for OCD. These include an in‐depth look at the impact of silence on the young person, integration of process‐guiding tools and the counsellor not enabling compulsive in‐session rituals. [ABSTRACT FROM AUTHOR]

Parents and carers are likely to take on a significant responsibility for managing an adolescent's mental health and well‐being. Accordingly, their perceptions provide insight into the value of an intervention. This study explored parents' and carers' perceptions and expectations of school‐based humanistic counselling, as received by a socially diverse group of young people (13–16 years old) in secondary schools in Greater London, UK. Semi‐structured interviews from 17 parents and carers were analysed thematically. Two superordinate themes were identified: (a) the context of counselling, and (b) the content of counselling, the latter referring to stages of the therapeutic process and its outcomes. Schools were perceived as an ideal environment for the provision of professional mental health support, as it reaches young people in a natural, convenient setting and therefore promotes and/or widens access to universal support, as well as targeted interventions. Parents and carers further emphasised the importance of overall well‐being, academic performance and social relationships. [ABSTRACT FROM AUTHOR]

In the case of psychological treatments, these outcome monitoring tools consist of psychological self-report scales (patient-reported outcome measures, PROMs), which are filled out by the patient usually before each session to capture ongoing therapeutic change. Routine outcome monitoring (ROM) is the regular assessment of patient outcomes to evaluate clinical progress during the course of therapy. Idiographic patient reported outcome measures (I-PROMs) for routine outcome monitoring in psychological therapies: Position paper. [Extracted from the article]

Pre‐pandemic research has suggested that video counselling is as effective as face‐to‐face practice. However, the mass migration of therapy to the online video domain as a result of the COVID‐19 pandemic makes it essential to interrogate the evidence base. This paper provides a critical commentary on how video therapy is defined/labelled, the current evidence about whether video therapy is effective, and whether the working alliance and therapeutic relationship functions differently in video counselling. The paper concludes that while the evidence to date is promising, it is limited in quantity and applicability and hence generalisability. Lack of evidence is not evidence that video therapy is ineffective, but the large gaps in understanding highlight the importance, both ethically and empirically, of further research in this area. [ABSTRACT FROM AUTHOR]

Within the UK, there has been a growth of services delivering online therapy to young people. This study identifies the factors that young people find helpful and unhelpful in synchronous text‐based therapy (STBT), and the processes by which these factors may be of value. Thirteen young people, aged between 14 and 18, were interviewed synchronously online. All participants had had a minimum of four sessions of STBT. Data were analysed thematically. Four main domains of helpful and unhelpful factors were identified: 1) anonymity, 2) access, 3) communication, and 4) control. Control was a particularly important element for young people and was an underlying aspect across all themes. Young people not only valued several aspects of STBT but also recognised its limitations. Further research should explore the contexts in which online counselling may be helpful or not. [ABSTRACT FROM AUTHOR]

Background: The i‐THRIVE Programme is a needs‐based model of care, based on the THRIVE Framework, that is being implemented across the United Kingdom with the aim of improving outcomes for children and young people's mental health and wellbeing. This study aimed to investigate the impact that this programme has on accessibility and quality of care, as viewed by key stakeholders. Methods: Interviews with professionals and service users were conducted during the implementation of the THRIVE Framework in four sites of one mental health and community service provider. Results: Three themes are identified: 'impact of needs‐based groupings on referral', 'impact of collaborative and interagency approach' and 'impact of i‐THRIVE on clinical practice'. Findings suggest that accessibility was seen to be promoted through the integration of a needs‐based approach, flexible re‐referral, signposting and information sharing, the use of goal‐orientated interventions and collaboration over risk and treatment endings. Shared decision making was perceived to improve the experience of care for young people, as was interagency working. Goal‐focused interventions and upfront discussion of treatment endings were seen to help clinicians manage expectations and discharge but could also compromise effectiveness and engagement. Obstacles to impact were resistance to interagency working and a shortage of resources across the system. Conclusions: i‐THRIVE is a promising approach with the potential to facilitate the accessibility and quality of mental health care. However, a tension exists between enhancing accessibility and quality of care, which points towards the importance of outcome and satisfaction monitoring. Obstacles to impact point to the importance of a whole‐system approach supported by sufficient resources across the locality. [ABSTRACT FROM AUTHOR]

The British Association for Counselling and Psychotherapy (BACP) is the largest professional membership body within the field of counselling and psychological therapies in the UK, but there is a mismatch between its membership of >65,000 and its research impact. This article sets out a potential strategic direction as considered by an informal grouping of researchers and teachers in the field. Actionable research plans are outlined at three levels: client–practitioner, local communities, and societies. At the client–practitioner level, data‐informed practice can be readily implemented as a therapeutic aid akin to supervision, providing the potential for integrating research into everyday practice. At the community level, interdisciplinary collaborations together with a focus on equality, diversity, and inclusiveness are paths to building a community of researchers and citizens that includes marginalised populations. The importance of social justice extends to the societal level, connecting with politics at a micro and macro level, and engaging internationally to respond to actual threats (e.g., climate change). Across these three levels, high value is placed on data with its potential for informing and improving practice, but also enhancing the lives of people in communities and societies. Overall, research strategies need to be collaborative (i.e., collegial) and less singular (i.e., individually project‐based), developing cumulative knowledge around specific topics via a ‘capture and build’ strategy for small projects with strategic oversight by BACP. Clarity of research strategy combined with collaborative and collective action from BACP and leaders in the field can help realise the full potential of BACP's research capacity. [ABSTRACT FROM AUTHOR]

A conceptual framework rooted in existentialism is presented to unify psychological and sociopolitical perspectives. Human beings are directional, with well‐being the actualization of highest order directions. Distress emerges through external blocking of directions, or through dysergetic or ineffective internal configurations. Hence, social justice work and counseling have essential, and integrated, roles. [ABSTRACT FROM AUTHOR]

Mental health and general health care research has shown that practitioners can facilitate patient involvement in shared decision making (SDM) and that the approach can benefit patients who wish to take part in decisions around their care. Yet patient experiences of SDM within a psychotherapy context have been little researched. This study examined how clients experienced SDM in a collaborative‐integrative psychotherapy. A grounded theory approach used interpersonal process recall interviewing and supplementary semi‐structured interviews to investigate 14 clients' experiences of SDM in pluralistic psychotherapy for depression. Verbatim transcripts were coded into 819 meaning units across six categories containing 13 subcomponents that comprised a single, core category. The six categories were (a) experiencing decisions as shared, (b) psychotherapists supporting clients to become more active in the decision‐making process, (c) both parties presenting and recognizing expert knowledge, (d) clients felt recognized as an individual and accommodated for by their psychotherapist, (e) clients felt comfortable engaging with the decision‐making process, and (f) daunting for clients to be asked to take part in decision discussions. A core category emerged of "Psychotherapists encourage client participation and progressively support clients to provide information and contributions towards shared treatment decisions that could be led equally, or marginally more by one party." Such support was particularly useful when clients had difficulty contributing as part of decision discussions. Client preferences for SDM change across clients and across decisions, highlighting the importance of practitioners remaining flexible to individual clients when using the approach. [ABSTRACT FROM AUTHOR]

Objectives: To determine the demographic profile of clients accessing voluntary and community sector (VCS) counselling services for young people and young adults, and to undertake the first systematic evaluation of outcomes. Design: Naturalistic, non‐experimental study design. Methods: A total of 2,144 clients were recruited from nine services in England. Data on gender, age, ethnicity, number of sessions, problem descriptions, and initial levels of psychological distress were collected from clients. Calculations of reliable and clinically significant change, repeated measures t‐tests, effect size estimates, and moderation analyses were undertaken to determine whether pre–post change, over an average of 5.1 (SD = 5.3) sessions, was significant and which variables predicted outcomes. Levels of service satisfaction were also recorded. Results: The demographic profile of clients accessing VCS services was distinct to those accessing statutory and school‐based counselling services, with a greater representation of females, 'older' clients, and clients from Black and Minority Ethnic (BME) groups. Clients accessing VCS counselling services presented with multiple and complex needs. Statistically significant reductions in psychological distress were observed with effect sizes ranging from.64 to.80. High levels of service satisfaction were expressed by clients. Conclusions: This study establishes that clinical outcomes in the VCS are comparable to those reported in school‐based and statutory mental health services in the United Kingdom. VCS services were perceived as being highly accessible and appear able to reach marginalized groups who may not be accessing other services. Practitioner points: VCS services in the United Kingdom may be more accessible to young people from marginalized groups, such as those from BME backgrounds, compared to statutory and school‐based counselling services.Counselling in VCS services is associated with significant short‐term reductions in psychological distress, at a level comparable with the statutory and educational sectors.Clients accessing counselling in VCS services report relatively high levels of service satisfaction. [ABSTRACT FROM AUTHOR]

The establishment of counselling and psychotherapy as "evidence‐based" interventions is contingent on the effective implementation of randomised controlled trials (RCTs) in real‐world clinical settings. This paper identifies some of the pitfalls that led to the termination of a practical RCT in a community mental health setting. It reflects upon the significance of the lessons learned by drawing on similar challenges that are documented in the wider literature. Issues surrounding staff turnover, counsellor engagement and procedural clarity are discussed, as is the conflict between the time required for research procedures and counsellors' clinical time constraints. In our recommendations, we recognise the decisive role of collaboration and counsellor motivation in research partnerships, and the significance of clinical relevance, communication, training and research co‐production in achieving them. Time commitment is identified as the pivotal challenge in the formation and maintenance of collaborative research, but one that also must be overcome for the advancement of the counselling and psychotherapy field. [ABSTRACT FROM AUTHOR]

Objectives: Goal‐oriented practices are central to many contemporary psychotherapies. The aim of this study was to explore clients' experiences of this work. Design: Mixed methods, with a main qualitative part and a smaller quantitative component. Participants were 22 clients in integrative psychotherapy (15 females, 6 males, 1 "other"). Semistructured interviews after session 4 and at endpoint were analyzed thematically. On the basis of the identified themes, "goal attitude" scores were developed and their correlations with outcomes investigated. Results: Goal‐oriented practices could help clients move from intention to action through increased awareness and focus, setting manageable tasks, and progress monitoring. However, they had the potential to hinder clients' awareness of their intentions, feel irrelevant, disorientating, or demotivating. Effectiveness hinged on client's management of their expectations, flexible working, and time. Positive attitudes toward goal‐oriented practices were associated with improvement. Conclusions: Goal‐oriented practices can enhance psychotherapeutic work but need to be individually tailored and implemented collaboratively. [ABSTRACT FROM AUTHOR]

Client preferences in psychotherapy reflect specific conditions and activities that clients desire in their treatment, with increasing evidence pointing to preference accommodation as facilitating psychotherapy outcomes. This updated meta‐analysis establishes the magnitude of the effect of client preference accommodation in psychotherapy. Based on data from 53 studies and over 16,000 clients, preference accommodation was associated with fewer treatment dropouts (OR = 1.79) and more positive treatment outcomes (d = 0.28) than providing client with a nonpreferred treatment or psychotherapy condition. The preference effect was moderated by study design, timing and type of outcome measurement, and client diagnosis. It was not moderated by year of publication, treatment duration, preference type, treatment options, client age, client gender, client ethnicity, or client years of education. The authors provide a case example of preference accommodation and practice recommendations for working with client preferences. [ABSTRACT FROM AUTHOR]

Abstract: Background: Life events are recognised to link low socio‐economic status (SES) with impaired mental health. Despite attention to patients’ historical environmental circumstances in psychotherapeutic practice, events that occur over the course of counselling and psychotherapy (‘intercurrent’ events) seem to have received little attention in research. Method: Life events were defined to include those that are chronic and severe, as well as minor, everyday occurrences. Outcomes were restricted to internalising problems related to depression and anxiety in child, or adolescent participants. Bibliographic databases and citations and review reference lists were searched, and relevant scholars were contacted. The conceptual and methodological nature of the literature is reported. Results: This review included 42 studies. Intercurrent events varied in severity and duration. Events were most frequently measured using questionnaires. The same questionnaire was rarely used in more than one study, and questionnaires were often adapted for use for the study's purpose/population. Events included in analyses tended to be analysed as a mediator of change in psychiatric symptomatology, or an outcome of therapy. Conclusions: Attention to intercurrent life events appears rare in psychotherapy research. This contributes to a systematic neglect of socio‐economic issues in psychotherapy research and arguably psychotherapy more generally. This neglect is exacerbated by a lack of agreed measures of life events, both intensive and routine in nature. Recommendations are made to improve attention to such events. [ABSTRACT FROM AUTHOR]

Abstract: Background: This study is a qualitative analysis of clients’ experiences of a new avatar based counselling intervention, based on the ‘ProReal’ software ( www.proreal.world). The intervention was piloted in eight secondary schools in the UK in 2016. Aims: Twenty‐nine participants (53% of the full sample) were interviewed about their use of the software, experience of the intervention, process of change and views about its helpfulness. Materials and Methods: Interviews were semi‐structured and were analysed using thematic analysis. Results: The analysis shows that the intervention was potentially attractive to these clients, particularly those enthusiastic about digital software and clients who found visual communication helpful. The software provided additional opportunities for clients to communicate their inner worlds to the counsellor and supported the development of insight. Male clients, in particular, commented on its helpfulness. Discussion: There is an indication that digital imagery supported the process of change in counselling and the development of meaning bridges: both internally and with the counsellor (Stiles, 2011; Stiles et al., 1990). However, the software could be experienced as an obstacle when clients wanted to talk about specific problems or ‘vent’ their feelings. All clients who reported that they did not find the software helpful were female. There were a number of suggestions about developing the software to increase opportunities for expression as well as appropriateness for clients from different minority ethnic backgrounds. Conclusion: Use of digital software in counselling has a potential to enhance communication and support a process of change, particularly with male clients, those who find visual communication helpful, and clients enthusiastic about digital technology. Further research is needed to develop the intervention and compare it to the use of other creative media in counselling. [ABSTRACT FROM AUTHOR]

The generation of sulfonyl radicals from sulfonyl azides using visible light and a photoactive iridium complex in THF is described. This process was used to promote sulfonylative and azidosulfonylative cyclizations of enynes to give several classes of highly functionalized heterocycles. The use of THF as the solvent is critical for successful reactions. The proposed mechanism of radical initiation involves the photosensitized formation of a triplet sulfonyl nitrene, which abstracts a hydrogen atom from THF to give a tetrahydrofuran-2-yl radical, which then reacts with the sulfonyl azide to generate the sulfonyl radical. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to examine clients' perspectives regarding the helpful aspects of pluralistic therapy for depression. Method Thirty-nine clients received psychological treatment in a multi-site study exploring alternative interventions to standardised 'evidence-based' approaches. Eighteen of them consented to a face-to-face or telephone change interview at the end of their treatment. Change interviews aim to elicit clients' perspective regarding changes that they noticed during, and after, therapy and also the possible causes of these changes. Their descriptions were transcribed and analysed thematically using explicit coding of themes which were audited by the research team. Findings The data were categorised in three a priori domains consisting of specific themes. The first domain constitutes of client-originated helpful factors including clients' positive perspectives of therapy, clients' overall effort to change and clients' contribution in the decision-making process of therapy. Therapists were perceived as helpful when they were accepting and respectful, empathic, responding to clients' needs, making clients feel comfortable, challenging, empowering, using techniques, flexible and reassuring. Treatment outcomes such as change in perspectives, behaviour and response to problems as well as increased insight were also considered helpful factors of therapy. Conclusion These findings suggest that clients in pluralistic therapy are active agents of change and their willingness to engage with treatment is crucial. Helping clients feel comfortable by creating a safe therapeutic environment, challenging dysfunctional patterns associated with depression and empowering them to believe that change is possible through reassurance and non-intrusive guidance were considered beneficial. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to pilot a test of the effectiveness of school-based humanistic counselling (SBHC) in an ethnically diverse group of young people (aged 11-18 years old), with follow-up assessments at 6 and 9 months. Design Pilot randomized controlled trial, using linear-mixed effect modelling and intention-to-treat analysis to compare changes in levels of psychological distress for participants in SBHC against usual care (UC). Trial registration: ISRCTN44253140. Methods In total, 64 young people were randomized to either SBHC or UC. Participants were aged between 11 and 18 ( M = 14.2, SD = 1.8), with 78.1% of a non-white ethnicity. The primary outcome was psychological distress at 6 weeks (mid-therapy), 12 weeks (end of therapy), 6-month follow-up and 9-month follow-up. Secondary measures included emotional symptoms, self-esteem and attainment of personal goals. Results Recruitment and retention rates for the study were acceptable. Participants in the SBHC condition, as compared with participants in the UC condition, showed greater reductions in psychological distress and emotional symptoms, and greater improvements in self-esteem, over time. However, at follow-up, only emotional symptoms showed significant differences across groups. Conclusions The study adds to the pool of evidence suggesting that SBHC can be tested and that it brings about short-term reductions in psychological and emotional distress in young people, across ethnicities. However, there is no evidence of longer-term effects. Practitioner points School-based humanistic counselling can be an effective means of reducing the psychological distress experienced by young people with emotional symptoms in the short term., The short-term effectiveness of school-based humanistic counselling is not limited to young people of a White ethnicity., There is no evidence that school-based humanistic counselling has effects beyond the end of therapy. [ABSTRACT FROM AUTHOR]

Background: Recent research has indicated that school‐based humanistic counselling (SBHC) is effective for young people in reducing psychological distress and facilitating achievement of personal goals. However, the processes by which this form of counselling brings about change are not yet understood. Aim: This study aims to clarify the dynamic processes of change that young people go through when they attend SBHC, in order inform school counselling practice, training and further research. Method: This is a qualitative interview study with 14 participants who had recently completed between two and nine sessions of SBHC as part of a randomised controlled trial (RCT). Interviews were transcribed and analysed using a grounded theory approach resulting in the development of five change process models. Results: Multiple change processes were evident for individual clients; and were labelled relief, increasing self‐worth, developing insight, enhancing coping strategies and improving relational skills. Implications: The data indicate that multiple pathways of change are possible, and that change processes associated with different theories of personality change are not mutually exclusive. The study is limited by a small, selective sample and low testimonial validity, and further qualitative research is needed to understand change processes in SBHC more fully. [ABSTRACT FROM AUTHOR]

Background Many outcome measures for young people exist, but the choices for services are limited when seeking measures that (a) are free to use in both paper and electronic format, and (b) have evidence of good psychometric properties. Method Data on the Young Person's Clinical Outcomes in Routine Evaluation ( YP- CORE), completed by young people aged 11-16, are reported for a clinical sample ( N = 1269) drawn from seven services and a nonclinical sample (N = 380). Analyses report item omission, reliability, referential distributions and sensitivity to change. Results The YP- CORE had a very low rate of missing items, with 95.6% of forms at preintervention fully completed. The overall alpha was .80, with the values for all four subsamples (11-13 and 14-16 by gender) exceeding .70. There were significant differences in mean YP- CORE scores by gender and age band, as well as distinct reliable change indices and clinically significant change cut-off points. Conclusions These findings suggest that the YP- CORE satisfies standard psychometric requirements for use as a routine outcome measure for young people. Its status as a free to use measure and the availability of an increasing number of translations makes the YP- CORE a candidate outcome measure to be considered for routine services. [ABSTRACT FROM AUTHOR]

Background: There is a growing body of data to show that participation in school‐based counselling is associated with significant reductions in psychological distress. However, this cannot be taken as evidence that school‐based counselling is effective, as improvements may have happened without the intervention. Aims: The purpose of this study was to develop a method of estimating the amount of ‘natural’ change that might be expected in young people who would attend school‐based counselling, such that the effects of the intervention over and above this amount could be identified. Method: Young Person's CORE (YP‐CORE) scores from 74 participants allocated to waiting list control conditions in four pilot trials of school‐based counselling in the UK were re‐analysed using regression models, and a formula was found for estimating the outcomes for young people were they not to receive counselling. This was termed their Estimated Non‐intervention Outcome (ENO), and could then be compared against the young person's Actual Outcome (AO), to give an estimated intervention effect (EIE). Results: The formula for the ENO was 4.17 + 0.64 × baseline score. Using this, we calculated a mean EIE for 256 young people in a cohort evaluation study of school‐based counselling, which showed that the counselling was associated with large and significantly greater change than would be expected without the intervention (Cohen's d = 0.91). Discussion: The method presented in this paper is a simple means for improving the accuracy of estimations of treatment effectiveness, helping to adjust for changes due to spontaneous recovery and other non‐treatment effects. [ABSTRACT FROM AUTHOR]

Background: The outcomes of counselling in UK primary schools are still largely unknown, and no clear predictors of change have been identified. This study is the largest evaluation to date of change and predictors of change in this sector. Method: The outcomes of Place2Be's play‐based counselling intervention for 3222 distressed children, aged 4–12, in 178 schools across the UK were evaluated. A naturalistic quantitative design was used, and the primary outcome was changed from baseline to endpoint on the teacher‐rated Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Outcome predictors were analysed using multilevel modelling. Results: The intervention was associated with significant reduction in psychological distress, with an effect size (Cohen's d) of.48 and clinical improvement of 50.3% of children. Greater improvements were found for children with higher baseline levels of distress, girls and bilingual children, while improvement of the children with a statement of educational needs was progressively compromised with increasing level of special educational needs. Discussion: Robust evidence now exists that a play‐based counselling model is associated with significant reductions in psychological distress in primary school children. However, more qualitative and quantitative research is needed to assess the effectiveness of this intervention and the key factors that predict change. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to replicate and extend a pilot evaluation of the effectiveness of school‐based humanistic counselling for psychological distress in young people. Method: Data were available on 32 young people who were randomised to either school‐based humanistic counselling or waiting list conditions for one school term. The primary outcome measure was of psychological distress using the Young Person's CORE (YP‐CORE), at six and 12 weeks post‐assessment. Secondary measures at these time‐points were of psychological difficulties, self‐esteem, levels of depression, and attainment of personal goals; with longitudinal evaluation of outcomes at six months post‐assessment. Results: On the primary outcome measure, participants who received counselling were significantly less distressed at six weeks than those in the waiting list group but not at 12 weeks, with effect sizes (Cohen's d) of 0.59 and 0.39 respectively. Reductions in psychological distress were maintained at follow‐up. Discussion: Although the present findings, in isolation, are equivocal, they contribute to a body of evidence that supports the effectiveness of school‐based humanistic counselling. However, the principal lesson learnt from this study was the need for rigorous training of researchers, counsellors and pastoral care teachers to ensure adherence to protocols. [ABSTRACT FROM AUTHOR]

Aim To investigate what clients found helpful and unhelpful in counselling following breast cancer. Method Fourteen women with a diagnosis of primary breast cancer were asked to complete a Helpful Aspects of Therapy ( HAT) form (Llewelyn, 1988) following each of their counselling sessions at a branch of a UK breast cancer charity, and these were analysed using grounded theory. Findings Participants identified six core helpful aspects of counselling, which were focusing on self, expressing and exploring feelings, problem solving, experiencing a helpful therapeutic relationship, experiencing relief and gaining reassurance, and understanding other(s). Unhelpful aspects of counselling identified were experiencing unwanted thoughts/feelings/behaviours, and the therapist trying something that did not fit/work for the client. Conclusions Participants indicated that counselling following breast cancer helped them to get back in touch with themselves, process strong emotions and resolve specific problems. By identifying a range of helpful processes, the analysis supports a pluralistic model of therapeutic change. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to deepen an understanding of the practices that bereaved clients find helpful in counselling. Method Semi-structured qualitative interviews were conducted with seven clients who had participated in counselling for bereavement within a voluntary organisation in Scotland. Data were thematically analysed within an overall framework of interpretative phenomenological analysis. Findings Respondents identified five helpful aspects of counselling. First, the independence of the counsellor: That they were outside the family and social network. Second, the counsellor's skilled listening: Being attentive, welcoming, demonstrating competence and being 'to the point'. Third, the non-directivity of the counselling work: Being allowed to take the lead and to talk on a range of issues, both bereavement and non-bereavement related. Fourth, having their unhelpful thinking challenged, being encouraged to see things from a broader perspective and through addressing their feelings of guilt and anger. Fifth, by having their responses to bereavement normalised through psycho-education and therapist self-disclosure. Conclusion The findings support previous research which suggests that both more, and less, directive interventions can be helpful for clients who experience bereavement. This is consistent with a pluralistic perspective, which holds that no one therapeutic orientation has a monopoly on helpful therapeutic practices. The findings suggest that helpful practice with bereaved clients may involve a client-led approach in which there is the establishment of a strong, supportive and attentive therapeutic relationship, but in which the therapist also brings in more directive interventions to help the client normalise and address their feelings. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to identify dimensions for a new pair of supervisory tools: the supervision personalisation form ( SPF) and the supervision personalisation form - assessment ( SPF-A). These are intended to help tailor supervisory work to the individual supervisee's needs and preferences. Method Semi-structured qualitative interviews were conducted with 15 accredited supervisors (four males and 11 females), principally counsellors and psychotherapists of an integrative or humanistic orientation, to identify the main dimensions along which their supervision practice varied. Data were analysed thematically using principles from grounded theory. Results Eleven dimensions of supervisory practice were identified: (1) Offering more, or less, theoretical input; (2) Focusing on the supervisee's strengths vs. focusing on their difficulties; (3) Focusing more, or less, on the supervisory relationship; (4) Providing more, or less, structure; (5) Focusing on the client's issues vs. focusing on the supervisee's issues; (6) Offering more, or less, self-disclosure; (7) Drawing from one, or more than one, orientation; (8) Offering more, or less, techniques and exercises; (9) Suggesting reading and reflection outside of supervision vs. not doing this; (10) More, or less, talking; (11) Directly challenging the supervisee vs. not directly challenging them. Discussion These 11 dimensions have been transposed into items for the SPF and SPF-A, which are now available for use in supervisory practice. However, further testing, evaluation and refinement of the forms is needed. [ABSTRACT FROM AUTHOR]

Background: Levels of goal agreement between therapists and adult clients have been shown to relate to therapeutic outcomes. Understanding clients' goals for therapy, therefore, is an important area of study. Aims: The purpose of this study was to investigate the therapeutic goals that young people have in school‐based counselling, and the extent to which different types of goals are achieved. Method: The study is a post‐hoc analysis of data collected from two pilot randomised controlled trials (RCT) using the Goal Based Outcome (GBO) tool, in which 73 participants were allocated to either a counselling group or a waitlist control group. Thematic analysis was used to identify the main types of goals young people had; with descriptive quantitative analysis to identify the prevalence of these goals, and multi‐level analysis to identify whether some goals were attained to a greater extent than others. Results: The most frequent type of goals identified by young people related to increasing self‐confidence and self‐acceptance, followed by controlling or reducing anger, improving relationships with family, and increasing feelings of happiness. No significant relationship was found between the type of goal and the extent to which they were attained in counselling. Conclusion: Young people in counselling are particularly concerned with improving their self‐confidence, and this suggests a somewhat different focus to the counselling work than that which emerges from counsellors' reports of presenting and predominant issues. This suggests that school‐based counsellors should be mindful of clients' particular therapeutic goals. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence of mental health issues in young people has contributed to a rise in the provision of school‐based counselling services in the UK. Between 2008/09 and 2010/11, data were collected from users of secondary school‐based counselling services in Wales. Aims: To identify the characteristics of users of school‐based counselling services in Wales – including demographics, referral pathways, presenting issues, and predominant issues – and how they compare to users of specialist CAMHS in Wales and Welsh secondary school pupils in general. Method: Data were collected on 10,687 episodes of counselling. School counsellors completed a client record sheet after each counselling episode and submitted these to their Local Authority. Collated results were then compared to matched data from Welsh specialist CAMHS and Welsh secondary schools data. Results/findings: A typical user of a secondary school‐based counselling service in Wales was female, of white ethnicity, and from the ‘middle’ school years. There was a marked under‐representation of users from BME backgrounds. Users were most often referred by school staff, and the most common presenting issues were family‐related, anger, and behaviour‐related. Conclusions: There was a higher proportion of females accessing school‐based counselling services than males. This was in direct contrast to data from specialist CAMHS and possible explanations for this are discussed. The under‐representation of BME populations suggested that there were some equality issues associated with accessing these services. Implications for practice: Future research should explore equality issues associated with young people from BME backgrounds accessing intervention services. [ABSTRACT FROM AUTHOR]

Background: The term outdoor therapy can be used to refer to a wide range of outdoor programmes including adventure therapy and wilderness therapy. Much of the research in the outdoor therapy field has focused on outcomes of these programmes rather than exploring the actual processes that are inherent in these experiences. Aim: This study investigated participants' perspectives of helpful aspects of outdoor therapy experiences. Method: By means of an international online survey, participants reported what was helpful about their experiences of outdoor therapy. A mixed method approach was used, with the qualitative data being analysed with the use of grounded theory methodology to conduct thematic analysis. The quantitative data was analysed using descriptive and inferential statistics. Findings: A total of 43 complete responses were received. Quantitative and qualitative analysis established that being in the outdoors was the most helpful factor. Of 19 given aspects ‘to be outdoors’ was ranked the highest and ‘being outdoors’ emerged as a main category in the thematic analysis (84%, (n=36)). ‘Group related aspects’ were all rated higher, on average, than ‘your relationship with therapist’. Such findings contradict previous research on how important the therapeutic relationship is in facilitating positive therapeutic encounters. Conclusion: Although very much a preliminary survey, findings suggest that further investigation into the meaning attached to being outdoors and how this might affect/impact upon the therapeutic relationship is needed. [ABSTRACT FROM AUTHOR]

Aims: School‐based humanistic counselling (SBHC) is a common psychological intervention for young people, particularly in the UK. However, studies have tended to suffer from high attrition rates, such that effects may have been over‐estimated. This paper describes a low budget ‘star topology’ practice research network (PRN) outcome evaluation of SBHC in a sample where attrition rates were minimised. Design: A practice‐based longitudinal study in a small PRN compared levels of psychological distress at first and last session from session‐by‐session data. Multilevel regression modelling was used to identify predictors of outcomes. Methods: Eight counsellors working across 11 schools agreed to use session‐by‐session self‐rating on the Young Person's CORE (YP‐CORE) yielding data from 256 young people aged 11 to 17. Predictors of outcomes were analysed using multilevel regression analysis. Results: Mean levels of distress on the YP‐CORE reduced from 18.29 (SD = 7.32) at baseline to 9.10 (SD = 6.19) at endpoint, giving a baseline to endpoint effect size of 1.26 (95% CI = 1.06–1.46). Lower levels of psychological distress at endpoint were associated with male clients, younger age groups, greater rates of attendance at counselling, and bereavement as a presenting problem. Conclusions: This ‘star topology’ PRN focused on a single study and demonstrated that such a system can provide relatively low cost, high quality data. The data showed that SBHC is associated with large reductions in psychological distress, and that this cannot be attributed to the high attrition rates of previous datasets. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to identify what patients with primary cancers found helpful in therapy.Method: In-depth qualitative interviews were conducted with eight patients who had completed a course of psychological therapy within an NHS psychology service for cancer patients. Data were analysed using thematic analysis.Results: The participants identified a range of helpful processes in therapy: talking and expressing their feelings to someone outside of the family; forming a relationship with their therapist; normalisation through the therapists' expert knowledge; problem-solving and CBT.Limitations: As with all qualitative studies, the small sample and size and dependence on participant recall limits generalisability of the findings.Implications: The findings of this study are consistent with a pluralistic perspective: that multiple therapeutic processes - aligned to a range of different orientations - can be of value to patients with primary cancers. This supports the provision of a range of therapeutic interventions and strategies for this patient group. [ABSTRACT FROM PUBLISHER]

Aims: The purpose of this study was to evaluate the outcomes of school‐based counselling, as delivered in the Welsh Government's School‐based Counselling Strategy, for reducing psychological distress in young people aged 11–18. Method: The study used a quantitative cohort design, comparing levels of distress on either the Young Person's CORE (YP‐CORE) or the Strengths and Difficulties Questionnaire (SDQ) from baseline to endpoint. Data were available on 3613 episodes of counselling, across 42 datasets. Meta‐analytical procedures were used to identify the mean effect size and predictors of outcomes. Results: Within each dataset, counselling was associated with significant reductions in psychological distress, with a mean effect size (d) of 0.93(95% CI = 0.89–0.97) using a fixed effects model and 1.09 (95% CI = 0.97–1.22) using a random effects model. Datasets using the YP‐CORE had larger effect sizes than those using the SDQ, and datasets with more complete response rates had lower outcomes than those with poorer response rates. Conclusion: The results confirm that school‐based counselling, as delivered in the UK, is associated with significant reductions in psychological distress, comparable to adult counselling and psychotherapy services. [ABSTRACT FROM AUTHOR]

Background: Representatives of counselling and person‐centred organisations indicate many of their members feel their profession and orientation is under threat, with counselling services being decommissioned in NHS settings. Aims: To understand the views of key figures in the psychological therapies field (policy makers, researchers and representatives of the counselling community) towards randomised controlled trials (RCTs), and their present and future role in developing the evidence‐base for counselling and psychotherapy. Method: Interviews (phone, Skype or face‐to‐face) were conducted with 24 authorities in the field. Relevant practitioner and academic networks were also contacted and key documents in the field were reviewed. Results: Key figures believe that RCTs will continue to play a decisive role in determining which psychological interventions are recommended and commissioned within the NHS for the foreseeable future. Other methods are seen as having some validity, but are generally considered supplementary to RCTs and not a replacement for them. Discussion: Although many members of the counselling community are critical of RCTs, they are likely to remain the mainstay of commissioning policy for some years to come. This means, in the coming years, members of the counselling community may face difficult choices in how to promote their work, while maintaining their core principles and values. [ABSTRACT FROM AUTHOR]

Background: Recent years have seen a growth in the provision of counselling within UK secondary schools, and research indicates that it is associated with significant reductions in psychological distress. However, little is known about the moderators and mediators of positive therapeutic benefit. In the field of adult mental health, motivation has been found to be one of the strongest predictors of therapeutic outcomes, and it was hypothesised that this may also be a predictor of outcomes for young people in school‐based counselling services. Aims: To assess the relationship between young people's motivation for counselling and its effectiveness within a secondary school setting. Sample: Eighty‐one young people (12–17 years old) who attended school‐based humanistic counselling services in Scotland. Method: Clients completed a measure of motivation for counselling at the commencement of their therapeutic work and a measure of psychological wellbeing at the commencement and termination of counselling. Results: Motivation for counselling was not found to be significantly related to outcomes. Discussion: The results indicate that the association between motivation and outcomes may be weaker in young people as compared with adults. However, a number of design factors may also account for the non‐significant findings: insufficient participants, marginal reliability of the motivation measure and social desirability effects. [ABSTRACT FROM AUTHOR]

Aim: To investigate young people's views on the effects of school‐based counselling, and what they found helpful and unhelpful. Method: Eleven semi‐structured interviews were conducted and thematically analysed. Findings: Participants expressed predominantly positive views of school‐based counselling with changes in three main domains: emotional, interpersonal and behavioural. Participants viewed these changes as having had an important effect on their lives. The most commonly cited helpful aspects of counselling were related to talking or getting things out, and counsellor qualities. Conclusions: School‐based counselling is viewed positively by those who have experienced it, and appears to be an appropriate and valuable intervention for young people. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this commentary is to argue that the value of counselling and psychotherapy research lies, not only in what it teaches us as therapists, but also in its ability to challenge us and our assumptions. Method: The paper identifies eight beliefs that may be prevalent in sections of the counselling and psychotherapy community, and presents evidence that challenges them. Findings: While many of our beliefs may hold true for some clients some of the time, the research evidence suggests that they are unlikely to be true for all clients all of the time. Discussion: By questioning and challenging therapists' a priori assumptions, research findings can help counsellors and psychotherapists to be less set in their beliefs; and more open to the unique experiences, characteristics and wants of each individual client. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to develop a comprehensive picture of the nature and outcomes of counselling in secondary schools in the UK. Method: Audit and evaluation studies of schools counselling were identified using a systematic literature search. Thirty studies were found and analysed using a variety of methods. Typically, counselling services provided purely person-centred, or person-centred-based, forms of therapy. Results: Averaged across all studies, clients had a mean age of 13.86 and attended for 6.35 sessions of counselling. The average percentage of female clients per study was 56.31%. Most frequently, clients presented with family issues, with anger issues particularly prevalent in males. Around 60% of clients began counselling with 'abnormal' or borderline levels of psychological distress. Counselling was associated with large improvements in mental health (mean weighted effect size = 0.81), with around 50% of clinically distressed clients demonstrating clinical improvement. On average, just over 80% of respondents rated counselling as moderately or very helpful, with teachers giving it a mean rating of 8.22 on a 10-point scale of helpfulness. For clients, the most helpful aspect of counselling was the opportunity to talk and be listened to, while pastoral care staff emphasised the counsellor's independence, expertise and confidentiality. There were some indications that counselling may indirectly benefit students' capacities to study and learn. Discussion: School-based counselling appears to be of considerable benefit to young people in the UK, but there is a need for this finding to be verified through controlled trials. [ABSTRACT FROM AUTHOR]

Background: There is a need for a user-friendly measure of change for use in school and youth counselling services which is easy for practitioners to administer and score, and which is appropriate for brief interventions. Aims: To develop such a measure and to present psychometric data on reliability, validity and sensitivity to change for the measure. Method: We employed a three-stage approach: first, creating a pool of potential items; second, developing an 18-item version; and third, refining to a final version comprising 10 items. We called the measure the Young Person's CORE (YP-CORE). Results: The measure comprised eight negative and two positive items and included a single (negatively-framed) risk-to-self item. Psychometric properties were all acceptable. Sensitivity to change was good and yielded an average improvement of 10 points on the YP-CORE in a clinical group, broadly equivalent to changes in adult versions (e.g. Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM)). Conclusion: Initial validation work showed the measure to be well designed and sensitive to change. Analysis showed considerable variability as a function of age and gender suggesting the need for the collection of a large and diverse data set in order to produce gender and age-specific norms. [ABSTRACT FROM AUTHOR]