Effectiveness and cost effectiveness trial of humanistic counselling in schools
| ISRCTN | ISRCTN10460622 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN10460622 |
| Protocol serial number | N |
| Sponsor | University of Roehampton (UK) |
| Funder | Economic and Social Research Council |
- Submission date
- 11/05/2016
- Registration date
- 16/05/2016
- Last edited
- 09/06/2025
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Mental and Behavioural Disorders
Plain English summary of protocol
Background and study aims
According to a report published by the World Health Organization in 2006, levels of mental health problems in children and young people are increasing. In 2010, UNICEF also reported that Britain is falling behind in promoting well-being in children. A study conducted by the Princes Trust in 2012 reported that 30% of young people aged between 16 and 25 reported that they always or often felt ‘down’ or ‘depressed’, and 21% felt that they did not receive the support they needed from school. Behavioral and emotional difficulties have been shown to negatively affect school attendance and educational achievement, which in the long-term can have a detrimental effect on employment and health. In several small sized studies, school-based humanistic counselling (SBHC) has been found to have good short term potential in terms of reducing psychological distress at a relatively low cost, however larger studies are needed to evaluate its true effectiveness. SBHC is a widely used counselling program which focuses on self-development, growth and responsibilities. The aim of this current study is to investigate the effectiveness of SBHC on psychological distress, and a range of other measures such as self-esteem, symptoms of anxiety and depression, school engagement and other educational indicators; as well as how cost-effective it is to deliver, in young people.
Who can participate?
Young people aged between 13 and 16 who attend a participating school and are experiencing moderate to severe levels of distress.
What does the study involve?
Participants are randomly allocated to one of two groups. Young people in the first group receive up to 10 sessions of humanistic counselling with a qualified school counsellor. This is based on the British Association for Counselling and Psychotherapy’s competencies framework for 11-18 year-olds. Young people in the second group receive their school’s usual pastoral care. After six-nine months, these participants are offered the opportunity to have up to 10 sessions of humanistic counselling with a qualified school counsellor. All young people taking part in the study are asked to complete some questionnaires at the beginning of their involvement, then 6, 12 and 24 weeks later in order to assess their mental health and educational attainment. Additionally some young people are also asked to take part in an interview with a researcher which aims to explore their experiences of counselling in more depth.
What are the possible benefits and risks of participating?
Participants benefit from the opportunity to access counselling, to contribute to the development of the researcher's understanding of counselling, and may also learn more about themselves. The majority of young people find that counselling is helpful to them. Additionally, participants will have the opportunity to provide their opinions and ideas about what is helpful to them when they are experiencing distress. Counselling sometimes involves talking about painful and difficult feelings. In addition, the questionnaires or researchers' questions may touch on some sensitive issues, so there is a small chance that this might led to upset or worry. The questionnaires may also feel boring or irritating to fill out.
Where is the study run from?
The study is run from University of Roehampton and takes place in 19 secondary schools in London, England (UK)
When is the study starting and how long is it expected to run for?
April 2016 to March 2019
Who is funding the study?
Economic and Social Research Council (UK)
Who is the main contact?
Professor Mick Cooper
Mick.Cooper@roehampton.ac.uk
Contact information
Public
Department of Psychology
University of Roehampton
Whiteland's College
Holybourne Avenue
London
SW15 4JD
United Kingdom
 ORCID ID |
0000-0003-1492-2260 |
|---|---|
| Phone | +44 (0)20 8392 3741 |
| mick.cooper@roehampton.ac.uk |
Scientific
Department of Psychology
University of Roehampton
Whiteland's College
Holybourne Avenue
London
SW15 4JD
United Kingdom
| ORCID ID |
0000-0003-1492-2260 |
|---|---|
| Phone | +44 (0)20 8392 3741 |
| mick.cooper@roehampton.ac.uk |
Study information
| Primary study design | Interventional |
|---|---|
| Study design | Randomized controlled trial |
| Secondary study design | Randomised controlled trial |
| Study type | Participant information sheet |
| Scientific title | Effectiveness and cost effectiveness Trial of Humanistic cOunselling in Schools |
| Study acronym | ETHOS |
| Study objectives | The aim of this study is to investigate whether: 1. School-based humanistic counselling (SBHC) is effective in reducing psychological distress in young people compared with pastoral care as usual (PCAU) 2. SBHC is a cost-effective way of reducing psychological distress in young people compared with pastoral care as usual |
| Ethics approval(s) | University of Roehampton, 16/08/2016, ref: PSYC 16/ 227 |
| Health condition(s) or problem(s) studied | Psychological distress |
| Intervention | Eligible participants are randomly allocated to the school-based humanistic counselling (SBHC) group, or the pastoral care as usual (PCAU) group. SBHC group: Participants take part in up to 10 weekly sessions lasting for approximately 45 minutes each of school-based humanistic counselling (SBHC) for psychologically distressed young people (aged 13-16). The intervention will be based on competences for humanistic counselling with young people aged 11-18 years (Hill, Roth & Cooper, 2014). PCAU group: The schools’ pre-existing systems for supporting the emotional health and well-being of students is in place for participants in this group. This will consist of established interventions which may involve a personal tutor, or a school inclusion lead, meeting regularly with the young person to speak about their difficulties. Participants in both groups are followed up at 6 weeks, 12 weeks and 24 weeks. A sample of participants are also asked to participate in an interview to explore their experiences of counselling in more depth. |
| Intervention type | Behavioural |
| Primary outcome measure(s) |
Primary outcome measures as of 12/07/2016: |
| Key secondary outcome measure(s) |
Secondary outcome measures as of 12/07/2016: |
| Completion date | 28/02/2019 |
Eligibility
| Participant type(s) | Other |
|---|---|
| Age group | Child |
| Lower age limit | 13 Years |
| Upper age limit | 16 Years |
| Sex | All |
| Target sample size at registration | 306 |
| Total final enrolment | 329 |
| Key inclusion criteria | Inclusion criteria as of 12/07/2016: In order to be eligible to take part in the ETHOS study, the young person must meet all of the following criteria at the point of assessment: 1. Aged between 13 and 16 years of age at the time of assessment 2. Be experiencing moderate to severe levels of psychological distress as assessed by a score of 5 or more on the Strengths and Difficulties Questionnaire (SDQ) Emotional Symptoms Scale 3. Able to speak and read English (with a minimum reading age of 13 years) 4. Want to participate in counselling, or want to undertake counselling, or want to see a counsellor 5. Not currently in receipt of counselling or any other therapeutic intervention that may be impeded through participation in the trial 6. Have a school attendance record of at least 85% as assessed by the school Original inclusion criteria: 1. Aged between 13 and 16 years of age at the time of assessment 2. Be experiencing moderate to severe levels of psychological distress as assessed by a score of >5 on the Strengths and Difficulties Questionnaire (SDQ) Emotional Symptoms Scale 3. Able to speak and read English 4. Not currently in receipt of counselling, or any other psychological intervention 5. Have a school attendance record of at least 85% as assessed by the school |
| Key exclusion criteria | Exclusion criteria as of 12/07/2016: 1. Considered by the researcher, as unable to provide informed consent (not ‘Gillick competent’) 2. The parent/carer of the young person has not provided their consent for the young person to take part in the study 3. Assessed by the researcher, or a teacher, to be at risk of serious harm to self or others at the time of assessment 4. Planning to leave the school within the academic year 5. Unwilling to complete all assessments 6. Unwilling to allow sessions to be audio recorded for the purposes of auditing Original exclusion criteria: 1. Considered by the researcher, as unable to provide informed consent 2. The parent/carer of the young person has not provided their consent for the young person to take part in the study 3. Assessed by the researcher, or a teacher, to be at serious risk to self or others at the time of assessment 4. Planning to leave the school within the academic year 5. Unwilling to allow sessions to be audio recorded for the purposes of auditing |
| Date of first enrolment | 05/09/2016 |
| Date of final enrolment | 30/03/2018 |
Locations
Countries of recruitment
- United Kingdom
- England
Study participating centre
Whiteland's College
Holybourne Avenue
London
SW15 4JD
United Kingdom
Results and Publications
| Individual participant data (IPD) Intention to share | Yes |
|---|---|
| IPD sharing plan summary | Stored in publicly available repository |
| IPD sharing plan | Added 28/02/2020): The datasets generated during and/or analyzed during the current study will be stored in a publically available repository after the current embargo until December 2020 at https://beta.ukdataservice.ac.uk/datacatalogue/studies/study?id=853764#!/details These datasets will include: 1. Participant-level quantitative data and statistical analysis will have open access availability 2. Qualitative data generated through interviews with clients, parents, and teachers analyzed by qualitative analysis methods which will be available on request to the Chief Investigator Consent from all participants was obtained to this data sharing and all data is fully pseudonymized |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Results article | results | 01/03/2021 | 25/01/2021 | Yes | No |
| Protocol article | protocol | 09/03/2018 | Yes | No | |
| Other publications | 14/01/2025 | 09/06/2025 | Yes | No | |
| Other publications | 12/06/2024 | 09/06/2025 | Yes | No | |
| Participant information sheet | Participant information sheet | 11/11/2025 | 11/11/2025 | No | Yes |
| Study website | Study website | 11/11/2025 | 11/11/2025 | No | Yes |
Editorial Notes
09/06/2025: Publication references added.
25/01/2021: Publication reference added.
07/10/2020: The following changes have been made:
1. The embargo date in the IPD sharing statement has been changed from June 2020 to December 2020.
2. The participant level data has been changed from "Not expected to be available" to "Stored in repository".
3. The intention to publish date has been changed from 01/04/2020 to 01/12/2020.
4. The public contact details has been changed and the plain English summary updated accordingly.
28/02/2020: The IPD Sharing statement has been added to the publication and dissemination plan.
19/02/2020: The intention to publish date has been changed from 30/09/2019 to 01/04/2020.
21/05/2019: The following changes were made to the trial record:
1. The overall end date was changed from 31/03/2019 to 28/02/2019.
2. The intention to publish date was changed from 31/10/2018 to 30/09/2019.
3. The total final enrolment was added.
4. Mr Chris Kelly replaced Prof. Cooper as public contact.
5. The plain English summary has been updated to reflect this change.
20/05/2019: The following changes were made to the trial record:
1. The public contact has been changed from Megan Stafford to Prof. Mick Cooper.
12/03/2018: Publication reference added.
05/09/2017: Ethics approval information added.
12/07/2016: The publication and dissemination plan and availability of participant level data have been added. In addition, the target number of participants has been updated from 324 to 306, and the outcome measures, inclusion criteria and exclusion criteria have been updated.
