The Way Forward for University Counselling Services:

Accessibility and Acceptability.

 “ I would like to say that I  think the Counselling Service is invaluable  to students, I have found it extremely useful and supportive personally and see very little that could be done to improve the service.” (Student feedback.)

Introduction.

This short presentation is essentially predicated upon four key position statements:

1.     Contextual Recognition. Universities and Colleges need to appreciate both the role and symbolic value of (student) counselling services, not only to individual students but to the organisation itself. Counselling services in their turn, possess particular specialised knowledge of the educational organisation context and thus are able to use this knowledge on behalf of their individual clients.

2.     Counselling services have a key role to play in stimulating the creation of a climate in which optimum learning can occur.

3.     The task of all staff (including the counselling service staff) in colleges and universities is to strive towards the creation of a humanly networked community so that all students may benefit from such interconnectedness.

4.     Accessibility and acceptability should be key factors in the development of university counselling services.

Some further notes to expand these four key points.

1. Contextual Recognition. The counselling service acts as a symbolic container for the institution’s anxiety. (This can be most apparent when, for example, the service might close for a short period within the summer vacation and a crisis is experienced with a student. The anxiety for this has then to be managed elsewhere.)

University counselling services in the U.K. are grossly under resourced for the task they are required to do, yet these same services are often much appreciated by clients who consult them and by other members of the organisation who refer individuals in distress or who require support in helping them support students.

Working within the educational context, counsellors appreciate the wide variety of demands upon students, each of which can, at some point, prove too much to handle, leading to depression, anxiety, a drop in work standards, withdrawal etc. Such demands include the sheer impact of various transitions upon the students’ psyches, (e.g. homesickness, culture shock, uprooting disorders, accommodation moves, training placements, overseas assignments etc.) of social pressures, financial matters, sexual identity, academic demands and so on.

2. Creation of a climate conducive to learning.

Translated into action points for a counselling service, this general aim could be re stated as: “one task of a University counselling service is to create a climate in which seeking help is deemed as a positive and healthy action.”

Within the wider institutional context, college administrators could transform this objective into practice through ensuring that the services delivered to students are friendly, responsive, efficient, effective etc.         

For academic colleagues, a focus on the processes that foster a conducive learning climate, particularly at the commencement of courses, would be immensely helpful to the student experience.

(The next point is closely related to the above and a natural development from it.)

3. Creation of a networked community.

Counselling service staff, within their “developmental” role, should support all activities within the institution that aspire towards the creation of a humanly networked community so that all students may benefit from such systemic interconnectedness.

One of the key factors in Barbara Rickinson’s doctoral research on student retention was that those students who dropped out or who came close to doing so reported that they were unable, at those points of crisis, either to locate sufficient resources inside themselves or in their immediate social vicinity, to help them through.

All staff, no matter what role or status they occupy, (e.g. cleaners, professors, porters, lecturers, caterers, secretaries, technicians etc.) can be key to a student’s well being at points of doubt and crisis.

4. Accessibility and Acceptability.

To ensure accessibility and acceptability, counselling services must strive to ensure that they are:

·        Physically,

·        Psychologically,

·        And Electronically accessible and are

·        Institutionally known and acceptable.

4a.Physically accessible:

The location of counselling services will inevitably impact upon how they are perceived as well as the comfort their locations appear to offer in terms of discretion of access. They need to be sited close to, but not on, major student “traffic” routes. Appropriate access routes must be ensured for mobility impaired clients. External lighting ensuring safe access in the dark (evening surgeries in winter) and clear signage is required.

Reception areas need to be warm, welcoming and receptive. This obviously applies both to the décor and to the reception staff.

4b.Psychologically Accessible and Available.

Advertising of the service needs to convey, through the style used and information transmitted, a welcoming and informative guide to using the service.

The Service needs to be well known within the university community so that referrals to it may be made by staff members when they are consulted by students in distress. (An extension of the networked community idea above.)

4c.Electronically Accessible.

The developments in this medium have expanded exponentially in recent years. Parallel to the overall development of computer communications and information technology in society, many university counselling services have launched extensive websites providing access to a wide range of information on their services, on mental health issues and links to other specialist sites. University Counselling Services have also co operated in an initiative to provide a wide range of virtual leaflets on mental health conditions.

Quite a few services have implemented forms of “online response” to enquiries made, electronically, by students.

There also exists a small but growing body of self help interactive computer based programmes for particular conditions that could be incorporated into helping programmes by counselling services, made available either on site or where possible via the computer medium.

4d.Acceptability.

(i)Background details.

“These sorts of problems are a canary in the mine shaft of culture. What are we doing to these young people? What do they need that they are not getting? We have enough data to show this generation is paying for it.” (Dr. Alishio, University of Miami Counselling Service.)

The concept of acceptability is a somewhat more complex aspect to address. In general terms, it does seem that the usage of counselling and psychotherapy services has become much more acceptable, culturally speaking, than it was twenty years ago. There are multiple references to these activities in the popular press, in literature and on the screen. Attitudinally, a societal shift seems also to have occurred in the preference now to “sort things out” and get to the bottom of them rather than resort to medication.

Many universities are now large communities ( Sheffield, for example, now has over 22000 students and 5,000 plus staff.) equivalent to the size of small towns. The resourcing of services such as counselling however, have not reflected the levels of need and demand placed upon them.

Counselling services are thus caught in the complex pincer movement of greater expectations of delivery and limited resourcing.

Much research work has been carried out in recent years on student mental health drawing attention to the complexity and seriousness of need experienced by students. A major survey conducted at the University of Cambridge over three years provided huge reams of data on student health and mental well being, one finding being that there was a body of students as large as the body who consulted a helping agency within the university, who were similarly distressed, who did not consult any one of those agencies. This finding both substantiates the size of the level of need within the student body and requires attentiveness, by counselling and other helping agencies, to the issue of acceptability.

(ii)Implications for Services.

“This is a vital service. Had it not been available, I would have left University.”

“Having to wait was hard as I was in a bad way and felt nobody cared.”

(Two student comments from an evaluation survey.)

Counselling services need to be (and be seen to be) available to all parts of the University community. The support of the Students Union and of senior staff within the University is a key element in this perception of availability.

The Association for University and College Counselling has a long held view that counselling services have three essential tasks, namely:

1.     individual work with clients,

2.     preventive work and

3.     developmental tasks.

Counselling services spend the majority of their time in responding to individual students in distress, this being the principal task.

However, the aspects of preventive and developmental work must not be ignored for these help to ensure service availability and effectiveness beyond the strict confines of the counselling office. Within these wider aims will fit committee and liaison work with departments, staff training activities (resident tutor training, personal tutor training) group work with students (anxiety management, relaxation, study skills, homesickness, public speaking, self esteem, managing relationships etc.)

Within this overall concept of availability, services have also to attend to issues such as

·        responding to student enquiries/requests for help within appropriate and realistic time frames,

·        maintaining appropriate conduct in relation to ethical issues such as confidentiality, in their every day practices,

·        where possible, ethical and practicable, giving feedback to the institution on any of its practices that seem to cause undue distress to/for students.

A Note on the Seriousness of Presenting Concerns by Students.

“There are clearly large and highly significant differences between this student population and a non clinical sample. These data are in fact remarkably similar to those given in the CORE manual for a clinical population.”

“Again, there is a very high degree of concordance with a clinical population derived mainly from NHS mental health services.”

“77 students in this cohort have indicated intentions to plan to end their own life.”

(Quotes from a CORE analysis of clients self rated distress levels upon entry into the counselling service at Sheffield during the year 2001-2002.)

The above comments are included in this text to draw attention to the fact that those who use counselling services have high levels of psychological and emotional distress. From earlier surveys conducted by the service at Sheffield, two thirds of student respondents have reported that their concerns about which they have chosen to consult, have a chronic element, going back more than one year.

A Brief Summary.

An attempt has been made in the above text to consider the challenges facing counselling services (and indeed universities) to support the overall mental well being in the student population as well as respond to the variety of individual demand made by students.

In short, these tasks are considerable in a system that has rapidly grown in population, a growth that has not seen parallel resourcing.

Counselling Services (as most other student services) are both student number and type sensitive. Any increases to the student population will inevitably create enormous pressures on counselling services and their capacity to respond sensitively and promptly to student need.

Counselling services have to maintain the quality of their continued work with individuals alongside their preventive and developmental roles. A key task within this purview will be that of rendering more visible the serious nature of present demands and thus requirement of enhanced resourcing needs.

Colin Lago

Director,

Sheffield University Counselling Service.

Oct. 2002.

ã Colin Lago 2002