research on school counseling effectiveness

Measuring the Value of a Strong School Counselor

• Posted February 19, 2020
• By Emily Boudreau

School counselors have long been understood as a key ingredient in college access , but the impact of counselors on student achievement has largely gone unmeasured. A recent paper from researcher Christine Mulhern , a Ph.D. student and PIER fellow at the Center on Education Policy Research at Harvard University , fills that gap, making clear just how valuable a counselor’s role can be. Indeed, Mulhern found that while teachers and counselors make an impact on students via different avenues, the effect of counselors is similar to that of teachers when it comes to educational attainment.

The findings offer more evidence of the value of the counselor role and suggest that a greater investment in school counselors may be as effective and more cost-effective than rolling out new college-going interventions that operate outside of schools, like online platforms or external mentoring opportunities. But the study also found that investing in counselors doesn't nececssarily mean hiring new counselors; it means investigating and sharing the practices of effective counselors so that more students can have access to the caliber of support they provide.

The Findings

Using methods similar to those used in teacher valued-added studies , Mulhern looked at a sample of quasi-randomly assigned high school students and their corresponding counselors from 131 schools in the state of Massachusetts. Her findings indicate that:

Counselors absolutely influence post-secondary achievement

Mulhern's paper finds that improving access to the type of support provided by the best school counselors may be a promising way to increase educational attainment and close socioeconomic gaps. By making the impact of school counselors explicit, the study provides an impetus for further investigation. Though her data did not provide detail on what practices effective counselors use, Mulhern thinks that her findings indicate that there are other avenues and levers that education leaders can consider, beyond classroom teachers, for driving opportunity.

Supporting effective counselor practices has value even when caseloads are high

There may be large benefits, like mental health outcomes, to drastic reductions in caseloads (like going from 500 students to 200), but for schools in which caseloads will remain high, focusing on developing effective counselor practices may be more cost-effective and influential. Working with a sample of counselors who had roughly an average of 285 students, Mulhern found that reducing caseloads from 285 to 220 students (which is the expected reduction from hiring one more counselor in the average Massachusetts high school) had only a marginal positive impact on educational attainment. But the paper suggests that the potential for leveraging effective practices among a school's existing counselors is significant.

Counselors can help students access information and opportunities

Mulhern shows that counselor practices, and the information they provide, can be vital in helping students access opportunities and apply to college, independent of classroom performance. “There’s this whole other area of things outside that traditional domain that students need assistance accessing, and counselors are particularly important for helping with that,” Mulhern says.

We should leverage the potential of all educators in a school

A large body of research suggests that classroom teachers are instrumental in student achievement, but Mulhern's study suggests the value of exploring how a school’s entire professional network — social workers, paraprofessionals, counselors — supports student achievement. “One thing I want to look at next," Mulhern says, "is the interaction between counselor and teacher effects — so, how are they working together, how are students navigating the different types of educators to whom they have access to figure out what they’re doing. Are they complementing each other?”

Moving forward

Counselors are a vital lever for advancing equity and educational attainment. But tapping the potential counselors offer doesn't necessarily mean that all schools need more of them. Rather, what's needed is a deeper understanding of the role counselors play, the practices that enable effective impact, and how to best match students with counselors. “Understanding that [counselors] can have important effects, but also knowing how to improve students’ access to effective counselors, is in line with a lot of policy and education goals,” Mulhern says.

Considerations for School Leaders

• What information do our most effective counselors have, and how are they leveraging this knowledge to support their students?
• Will reducing counselor caseloads be effective in this particular setting, or would expanding professional development opportunities have a greater impact?
• How can different types of educators with different expertise collaborate to provide an optimal learning environment, and how should schools deploy resources to support that mix?

Additional Resources

• Listen to the EdCast with Mandy Savitz-Romer to hear her talk about redefining the counselor role.
• School counselors weigh in on the college admissions scandal.

Usable Knowledge

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Effectiveness of school-based mental health programs on mental health among adolescents

Fariba shahraki-sanavi.

1 Department of Public Health and Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

Alireza Ansari-Moghaddam

2 Department of Epidemiology and Biostatistics, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

Mahdi Mohammadi

Nour-mohammad bakhshani.

3 Department of Psychiatric and Clinical Psychology, Children and Adolescents Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran

Hamid Salehiniya

4 Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran

5 Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran

This study aimed to investigate the effect of school-based interventions on mental health among adolescents in the southeast of Iran.

This interventional quasi-experimental study included a total of 420 adolescent girls studying 10 th grade in the public schools of Zahedan, Iran. Data were collected using general health questionnaire-28 questionnaire. After pretest, multidimensional interventions (individual education, group education, individual consultations, modern education, and parents' educational packages) were given to the intervention group from October 2015 to June 2016. After a 3-month interval, the posttest was conducted in October 2016. Data were analyzed by covariance analysis.

There was a significant statistical difference between the changes in the mental health scores after the intervention among the two study groups ( P < 0.05). Furthermore, after the intervention, moderate-to-severe mental health problems decreased considerably among the students in the intervention group compared to controls. The greatest impact was on individual psychological counseling.

CONCLUSIONS:

The results of the study showed that by applying group training and individual counseling in the schools improves mental health. Therefore, identifying student problems and parent–teacher cooperation as well as consulting with specialist counselors can be effective in providing practical and effective solutions in this regard. Therefore, findings suggest that prioritizing mental health and taking action on the field are of utmost importance.

At present, chronic non communicable diseases is a major cause of death, raising concerns in the healthcare systems worldwide. The World Health Organization (WHO) introduced “Healthy People 2020” within the framework of providing community healthcare, thus promoting health outcomes and establishing health equity. Accordingly, a number of leading health indicators, e.g., ensuring mental health, have been introduced for having healthy people.[ 1 , 2 ]

Mental disorders of adolescents could be associated with a wide range of features, including physical and cognitive health, mental functioning, social environment, family features, and stressful life events.[ 3 ] To this end, it is essential to provide and develop mental health programs and services in schools for identifying the specific needs of students who face innumerable mental health issues every day.[ 4 , 5 ] These programs not only identify mental health complaints but also offer diagnosis and treatment in schools. Therefore, schools must have counselors and psychiatrists to provide useful interventions for students with mental health problems.[ 6 ] In addition, they must refer these students to community mental health services for further care and treatment if it is needed.[ 7 ]

In addition, puberty and its specific crises, e.g., confusion and decreased self-esteem, further differentiate this period in terms of mental health.[ 8 ] Unfortunately, evidence suggests a high prevalence of mental disorders among adolescents.[ 9 , 10 , 11 , 12 ] Fifty percent of adult mental disorders are originated in childhood and adolescence.[ 13 ] The UNICEF reported a prevalence of mental health disorders in adolescents as 20%;[ 14 ] according to the WHO, 12%–29% of adolescents suffer from mental disorders in different countries,[ 15 ] and the prevalence of mental disorders in Iran is also reported to be 10%–40% by various studies.[ 16 , 17 ]

Consequently, schools should not ignore their determinant role in decreasing mental health problems. Schools can offer security and Privacy for students. It also provides parents and teachers partnerships for cognitive, behavioral, and emotional-functional supports for all students.[ 18 ] Studies demonstrated the effectiveness of school interventions in promoting mental health.[ 19 , 20 , 21 ] Moreover, the results of some studies emphasize direct educational methods and some indirect educational methods. According to this evidence, individual education and counseling were positive and had a great impact on the behavior of individuals.[ 22 ]

Further, data suggest a high prevalence of mental disorders in females compared to males due to biological factors, gender roles, environmental stress, and limitation of satisfaction source and social participation of females in society.[ 16 ] Furthermore, for girls, adolescence is the foundation of their future that guides the next stages throughout their lives and directly affects their future, family, and children. Then, investigating female adolescents' mental health status is essential because of their twofold role within the health of a community and impending generations' health.

Therefore, due to the importance of adolescence in human life as a basis for the present and future health, the present study was conducted to examine the effectiveness of school-based mental health programs on adolescents in Southeast Iran.

This interventional quasi-experimental study purposively included four public high schools that were similar in terms of social, economic, and environmental factors from among public girl's high schools in Zahedan, Iran.

Participants

Accordingly, selected schools were divided into experimental ( n = 2) and control groups ( n = 2). Using the census method, all the tenth-grade students were initially included in the study. Based on the early results of the study and the formula given below, in each group, 90–171 (total 342 students) sample size was estimated.

All 10 th -grade students attending school were enrolled in the study, and only students who moved from these schools or had long absences from school were excluded from the posttest phase. In the end, 420 students (300 in the experimental and 120 in the control groups) participated in the study.

Instruments

Mental health was assessed by a general health questionnaire-28 questionnaire with the most reliability, sensitivity, and specificity.[ 23 , 24 , 25 ] Persian version has also a criterion validity coefficient of 0.87 and reliability (α) of 0.90 of 0.97.[ 26 ] The questions were multiple-choice (no, a bit, high, and very high) which is scored based on the Likert scale (0-1-2-3). Finally, subscales based on the cut-off line for scores in each subscale were categorized into four categories of lowes (score 0–6), mild (score 7–11), moderate (score 12–16), and severe (score 17–21). The questionnaire was completed in 30 min.

Before data collection, the participants were given information on the research method, questionnaire completion, collaboration, trust, and confidentiality of responses. After obtaining informed consent from the students and their parents according to the ethical codes (IR.ZAUMS.REC.1394.251), the students' were enrolled. Further, a code was assigned to each participant for the confidentiality of the information.First, we administered the pretest. After analyzing the pretest results, the experimental group of adolescents who belonged to the “severe” category in each subscale was identified based on their codes.

After arrangements were made with high-school principals and assistants, the students' names and class numbers were identified without the type of disorder. Afterward, counseling sessions in the high schools were planned according to the class schedules and the number of sessions required for each student (four individual sessions for each disorder) based on the date and time.

The main investigator and three counselors had a joint meeting to determine the number of students and sessions for each counselor. Then, they were provided with the session dates and schedules, as well as the students' codes and types of problems. To protect the student's anonymity, the counselors had access only to the codes.

In a meeting in each high school, teachers were encouraged to collaborate for the counseling sessions. During the counseling period, if some students were absent on the specified dates or the session overlapped with midterm examinations, a make-up session was scheduled.

Each counseling session lasted for 45 min. The questionnaires were self-administered, and to avoid response bias, based on the type of problems, the counselors administered more accurate psychological tests on the first sessions, and the sessions continued if the identified problem was confirmed.

Information on mental health, mental problems, and solutions to the problems was published on the websites of experimental-group high schools. Moreover, 150-min workshops were held on mental health in all the intervention high schools. Every workshop included theoretical education, PowerPoint presentation, and video clips (100 min); question and answer, role-playing (30 min); and overall evaluation (20 min). In addition, as most adolescents complained of stress-related problems, we displayed posters on how to control stress in the intervention of high schools.

Mental health programs were implemented for the intervention group from October 2015 to June 2016 and the posttest was administered 3 months later in October 2016.

Data analysis

The data were coded and then analyzed in SPSS 15 (IBM Corp., Armonk, NY, USA). Descriptive statistics were used to categorize the data and determine the level of mental disorders. In addition, the effectiveness of interventions was examined using ANCOVA with 95% of a confidence interval.

In total, 420 tenth-grade students participated in the study. Half of the fathers were employees, while the mothers were homemakers and had high-school diplomas. In addition, most students in both groups lived with both parents and were the first to the third child. They described the socioeconomic status of their families as moderate to good.

The moderate-to-severe mental health problems of the students showed 1.6% and 5% increase in physical problems, 6.1% decrease and 6.9% increase for anxiety and sleep disorders, 3.4%, and 0.5% decrease in impaired social functioning, and 4.8% and 3% decrease for depression among the experimental and control groups, respectively [ Table 1 ].

Distribution of absolute frequency and percentage of mental health among the students of experimental and control groups over the past month

The mean scores of intervention group were pre-test and post-test, respectively 28.7 (15) and 26.7 (14.8) and for the control group 35.8 (17.8) and 37 (19.5) (Range of scores: 0-84). Based on Table 2 , the mean and standard deviation of changes in the mental health scores of students significantly differed across groups, showing a decrease of 2 points in the experimental group.

Univariate analysis of variance of mental health score between group

The mean of pretest scores was significantly different between two groups with independent t -test ( P =0.001), covariate variable: pre-test scores, a R 2 =0.009, η 2 =0.04

Schools are one of the most important human societies and one among the targets of healthcare systems. Along with families, schools play a role in preventing behavioral problems and enhancing the social capabilities of adolescents.[ 27 , 28 , 29 ] Therefore, the provision and development of mental health programs and services in schools seem to be essential for identifying the specific needs of students who face innumerable mental health issues every day.[ 30 , 31 ]

Findings suggest that schools must be equipped with certain facilities to determine the students' emotional, behavioral, and social needs. Moreover, having counseling centers outside the schools is an important step toward realizing this goal.[ 32 ] School counseling activities aim to resolve the students' social, family, educational, behavioral, and mental problems and pathologies, with counselors' playing the central role in this regard.[ 33 ] Moreover, consultations can improve various aspects of their health including mental and physical health.[ 27 , 34 , 35 ] Some studies indicated the effectiveness of counseling services for the students.[ 36 , 37 ]

Smith concluded that the students require real experiences and dislike being advised. Although advice may be actually helpful for them, they need tangible examples of real and difficult situations and counselors who would help them with encountering and understanding real-world situations.[ 38 ] In fact, students require guidance, encouragement, and practice, while no satisfaction is achieved if their needs are not structurally discovered.[ 39 ] Evidence suggests that individual education and counseling have a remarkable positive effect on individuals' behavior.[ 22 ] The results of the present study also demonstrated an improvement in the mental health scores of students who had received individual counseling.

A study on the effectiveness of brief school-based interventions on depression, anxiety, attention deficit hyperactivity disorder, and excessive alcohol consumption showed that the 12-month intervention positively affected emotion and negatively affected depression among students with negative thoughts. Depression was decreased in students with anxiety in both groups, although the effects were stronger in the intervention group.[ 21 ]

According to a meta-analysis, cognitive-behavioral approaches are more effective on people at risk of mental disorders.[ 40 , 41 , 42 ] In Chile, a clinical trial was conducted on adolescents from poor families. Results showed that school-based interventions based on a cognitive-behavioral model reduced the signs of depression in high-risk adolescents, such that after 3 months of intervention, the experimental group improved 10% more than the control group.[ 43 ]

In line with other studies, the present study offered a school-based intervention on mental health and individual counseling for students with specific mental health problems. Following the intervention, the moderate-to-severe anxiety and sleep disorders, impaired social functioning, and depression were significantly reduced in the experimental group compared to the controls.

Limitations

One limitation of the current study was the students who participated in this study were of the female public schools and grade 10 and therefore are not representative of all adolescents in this age group. In addition, the data collected were based on a self-administered questionnaire.

Weak and strong points of the study

• Strong – Plans adequate time to completed assignments and study
• Weak – Restrictions on making sustainable behavioral changes in students in this limited time period.
• Strong – Good cooperation of the education organization, directors, teachers, and students
• Weak – Poor parenting follow-up.

Conclusions

Authorities and health policymakers should acknowledge that the number of students suffers from severe mental health problems.

To sum up, the results indicated the high impact of minimum counseling sessions for each problem on students with mental health problems. In this regard, the education organization can benefit from the capacity of students' studying psychology.

On the other hand, given the importance of the family in Iran and due to the emotional dependency of adolescents to families in this age range, the strong impact of family in mental health is logical. Therefore, to provide mental health, the participation of school counselors and parent education seems necessary.

Financial support and sponsorship

Zahedan University of Medical Science.

Conflicts of interest

There are no conflicts of interest.

Acknowledgments

This article was part of Ph.D., thesis with code 2772 in Zahedan University of Medical Science We would like to express their gratitude to the Zahedan Medical Sciences University, the Health Promotion Research Center, the District Department of Education, and the school heads, teachers, and students who helped conduct this study.

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Effectiveness of school counselling revealed in new research News from BACP

It’s the first, large-scale study of its kind to be carried out in the UK

School-based humanistic counselling is effective and should be considered as a viable treatment option for children suffering from mental health issues despite its costs, new research has found.

The study, led by the University of Roehampton and in collaboration with our research team, is the first large-scale research into the effectiveness of school counselling in the UK.

Reductions in psychological distress

It found school-based humanistic counselling led to significant reductions in pupils’ psychological distress over the long-term, compared to pupils who only received pastoral care.

However, it was also revealed that this type of counselling comes at a cost, totalling between £300 and £400 per pupil.

With one in eight 5 to 19 year olds in the UK estimated to meet the criteria for a mental health disorder, the research provides critical evidence for schools considering expansion of their mental health services.

The research, published The Lancet Child & Adolescent Health, was conducted between 2016 and 2018 across 18 London schools and surveyed 329 children aged between 13 and 16 years olds at six-week intervals.

The study also found pupils who were offered counselling experienced significantly improved self-esteem, as well as large increases in their achievement of personal goals.

Vital study

Lead author of the paper, Mick Cooper, Professor of Counselling Psychology at the University of Roehampton, said: “Studies like ours, which is the first large scale project of its type ever to be conducted in the UK, are vital to assess how mental health services can be improved in schools.

“Our analysis found that school-based humanistic counselling works and makes a difference to the well-being of pupils, albeit at a cost. However, it also highlighted the importance to continue to study the provision of mental health support in schools and how other services, such as CBT, can be employed to tackle these issues.

Campaigning for school counselling

Jo Holmes, our Children, Young People and Families Lead, said: “As we continue to campaign for a paid counsellor for every school, this research provides us with crucial further evidence to highlight the difference counselling can make in improving children’s wellbeing and reducing their psychological distress. These new results about improved self-esteem and the focus on personal goals adds to the evidence base that we’re constantly raising with commissioners and policy-makers.

“Professionally delivered school counselling services are not cheap, and neither should they be. School counsellors are highly trained, experienced and skilled practitioners, often working with complex need and trauma linked to psychological distress. School counselling has the potential to take some of the short and long-term pressure off statutory provision, and can support young people as they transition to and from more specialist mental health services.”

The project lays important groundwork for further studies and explorations into the improvement of mental health provision for school children in the UK and costs, particularly with the ongoing impact that Covid-19 is having on young people’s mental health issues across the country.

Pressing need for provision

Professor Cooper added: “There is pressing need for a diverse and comprehensive mental health provision and care for young people in schools across the UK, but it is essential that this is properly assessed to establish what works and what should be widely implemented to improve the mental well-being of young generations.”

In this study, school-based humanistic counselling consisted of one-on-one sessions with a counsellor based in a school. Unlike therapist-led approaches, such as CBT, this is a child-centred approach, with children talking about their issues and developing solutions with the aid of the counsellor

The ‘Effectiveness and Cost-effectiveness Trial of Humanistic Counselling in Schools (ETHOS)’ study was carried out in collaboration with the London School of Economics (LSE), Manchester University, the University of Sheffield and the University of Kent, as well as the British Association for Counselling and Psychotherapy (BACP) and the National Children’s Bureau (NCB). It was also supported by the Economic and Social Research Council and Metanoia Institute.

Read the full open access study in The Lancet Child & Adolescent Health .

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