Understanding school-based counselling services in complex systems: Developing a whole system approach

Abstract

Objectives: Community sites, including schools, are important settings for interventions to promote children and young people’s mental health and wellbeing. A central provision to support mental health in the UK is school- and community-based counselling services. However, the evidence-base for school counselling services is limited by weak evaluation designs, lack of understanding of different counselling approaches in use, and a failure to conceptualise counselling services as part of a wider complex system. To address the last point, this article takes a complex system-focused perspective to explore how a ‘system disruption’, that is counselling service implementation, can be optimised in the Welsh education system. Design: The approach used in this study is a mixed-method qualitative design. Setting: Participants were recruited from school and community settings. They included children and young people, parents, carers, school staff, counsellors and stakeholders from health and education. Method: Consultations, key system stakeholder interviews and school case studies were conducted. All stakeholders were asked about their experiences of local authority-funded school- and community-based counselling services in Wales. Interview and consultation data were analysed using a thematic analysis approach. Results: Data converged into three main themes focusing on the specifics of counselling sessions, counselling services as part of universal mental health provision and a whole education system approach. These three themes are brought together into a complex systems-focused model of an optimised school- and community-based counselling service. Conclusion: The model offers an opportunity to address issues with current counselling services in Wales and improve outcomes and sustainability by increasing the likelihood they will become embedded in the whole education system.