Motivation as a predictor of outcomes in school-based humanistic counselling

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. To assess the relationship between young people’s motivation for counselling and its effectiveness within a secondary school setting. Eighty-one young people (12 - 17 years old) who attended school-based humanistic counselling services in Scotland. 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. Motivation for counselling was not found to be significantly related to outcomes. 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

Chronic fatigue syndrome

Objective. To acknowledge the dinical syndrome chronic fatigue syndrome (CFS) and outline the diagnostic criteria and reasonable management.Outcomes. Attempt at containment of treatment cost and improvement of the quality of care of patients with CFS.Evidence. Delphi-type commentary from 20 expert clinicians and appropriate organisations. Limited literature survey.Values. To clarify the reasonable management of CFS amid conflicting clinical opinion on a condition qf concern to patients, funders and doctors, An adaptation:of an existing guideline was sent to organisations and individuals for comment. Comments received were included in this guideline where possible.Benefits, harms and costs. To acknowledge a clinical syndrome with a reasonable approach to management considering the cost implications. No cost analysis was done.Recommendations. To recommend the following: (I) diagnostic criteria for CFS; (il) potential differential diagnoses and possible investigations; and (iil) management protocol.Validation. The draft guidelines were subjected to external review by individual doctors who are acknowledged CFS treaters, doctor groups and the patient support group. There were major disputes about the content, with the responses falling into two groups: thosewho do not believe CFS is a distinguishable illness, and those who do.Developer and funding. The Committee for Science and Education, Medical Association of South Africa, Endorsements. Medical Association of South Africa and national health care organisations (see list at the end of the document)

Randomised controlled trial of school-based humanistic counselling for emotional distress in young people: Feasibility study and preliminary indications of efficacy

The purpose of this study was to test the feasibility of a randomised controlled trial comparing six weeks of humanistic school-based counselling versus waiting list in the reduction of emotional distress in young people, and to obtain initial indications of efficacy. Following a screening procedure, young people (13 - 15 years old) who experienced emotional distress were randomised to either humanistic counselling or waiting list in this multi-site study. Outcomes were assessed using a range of self-report mental health measures, with the emotional symptoms subscale of the Strengths and Difficulties Questionnaire (SDQ) acting as the primary outcome indicator. Recruitment procedures were successful, with 32 young people consenting to participate in the trial and 27 completing endpoint measures. Trial procedures were acceptable to all involved in the research. No significant differences were found between the counselling and waiting list groups in reductions in levels of emotional symptoms (Hedges' g = 0.03), but clients allocated to counselling showed significantly greater improvement in prosocial behaviour (g = 0.89) with an average effect size (g) across the nine outcome measures of 0.25. Participants with higher levels of depressive symptoms showed significantly greater change. This study suggested that a randomised controlled trial of counselling in schools is acceptable and feasible, although initial indications of efficacy are mixed