Estimating effectiveness of school‐based counselling: Using data from controlled trials to predict improvement over non‐intervention change

Abstract

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.

Emotional Distress and Negative Automatic Thoughts of Students During Secondary School Education

“…Having in mind that the factor structure of the questionnaire is known, and it was not specifically investigated for the purposes of this study. Previous research has confirmed that the questionnaire is highly reliable, with Cronbach's alpha reliability indices ranging from .78 to .90 (5,6,(18)(19)(20)(21). High reliability indices were also obtained for this study (from .83 to .89; see Table 2).…”

“…Budući da je faktorska struktura upitnika poznata, za potrebe ovog istraživanja nije posebno provjeravana. Prethodna istraživanja potvrđuju da je upitnik visoko pouzdan s indeksima pouzdanosti tipa Cronbach alpha od .78 do .90 (5,6,(18)(19)(20)(21), a visoki indeksi pouzdanosti dobiveni su i u ovom istraživanju (od .83 do .89; tablica 2).…”

Exploring counselling outcomes in New Zealand schools

“…A smaller, more recent UK study revealed similar results: students who received school‐based counselling had lower psychological distress and emotional symptoms and greater self‐esteem than students who did not receive counselling at 6 and 12 weeks, but these effects were not present at 6 or 9 months after counselling ended (Pearce et al, 2017). Although these findings provided additional support for Cooper et al’s (2015) statement that school‐based humanistic counselling is associated with reductions in psychological stress for young people, additional evidence using larger samples and randomised control groups was recommended to demonstrate effectiveness.…”

“…Cooper, Fugard, Pybis, McArthur, and Pearce (2015) reanalysed data from waitlist controls in four pilot studies to obtain an estimated intervention effect (EIE) due to ‘natural change’ and then applied it to the scores of the 256 UK school students who received counselling. Applying the EIE formula to post‐counselling scores reduced the standardised effect size of 1.24 to 0.91, thus giving a more accurate estimate of the treatment impact, but one that still demonstrated ‘large and significantly greater change than would be expected without the intervention’ (p. 262).…”

Associations between family and clinician ratings of child mental health: A study of UK CAMHS assessments and outcomes

“…The SDQ is one of two child measures to provide an estimate of value added (AVS) by an intervention (the other is the YP-CORE for young people; Cooper, Fugard, Pybis, McArthur, & Pearce, 2015). There is evidence of regression to the mean in CGAS scores (Table 6) since the CGAS suggests improvement yet the AVS shows no change.…”