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.