Counselling Evaluation
2012
The counselling provided at WHAC is a free, confidential service for women and girls 14+. Thank you to all the staff and volunteers who are committed to providing clients attending WHAC with a professional, high quality service. Thanks also to the clients who attend and then take the time to complete the questionnaires. This helps us to ensure that we continually improve our services and that we are meeting their needs. This is a free service to clients, but is not free to deliver. It is available thanks to the continued support of our funders.
I first attended WHAC in 2009 and at that time I didn’t want to speak to anybody or give any eye contact. I was very low and had no self esteem. I felt my life was going nowhere and was drinking heavily. A friend had suggested I came to WHAC to see if they could help, this was hard for me to pluck up the courage to come. For the first few sessions I just responded when I needed to and found it very difficult to open up. There were times when I needed a drink before I came. I persevered and the more I came the easier it became to talk to people and give eye contact and look at my counsellor As the counselling progressed I gradually started to let people in after being surrounded by a brick wall. I had kept everything to myself and bottled my feelings up. It was hard to let things go but also a relief. I now realise that there is help out there and no-one needs to cope on their own. It was an uphill struggle but now things seem more worthwhile. Without WHAC I don’t know where I would have been now. My life is back on track and I’m happy again which I never thought would be possible.
You have helped me above and beyond the call. The times you phoned me back, you even phoned the police for me on one occasion. You accompanied me to the meeting with the Council and Escape to help me move from the village. You produced a taxi via WHAC for me to visit a house and take me back home. You did so many things for me; I could not list them all. Above all you conveyed to me how much you cared and understood whilst always, always being the epitome of professionalism. Thank you.
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WHAC uses a number of methods to evaluate the impact and the process of its counselling service. The information in this report is taken from data collected during 2011 In order to measure the impact of the counselling on clients we are using the Warwick Edinburgh Mental Health Wellbeing Scale, which is a measure of mental well being focusing entirely on positive aspects of mental health. The questions help obtain a snapshot of how a client is feeling at the first assessment, at the end of their counselling and then three months later. We have an ongoing system of evaluation to measure the counselling process in place for a few years now. Clients who have finished their counselling are contacted and asked to complete a client satisfaction questionnaire. There is no way of identifying the client from the returned forms. Clients sign a consent form giving us permission to contact them for evaluation purposes, so only those that agree are sent out forms. We only send forms to those that have attended their counselling sessions offered after the assessment appointment and do not write to clients who have chosen not to take up their counselling appointment. During the past year we have sent out 44 forms and have had 25 returned. The aims of this evaluation are: • To identify strengths and weaknesses of the counselling service • To assess whether clients perceive the service to be of a high standard. • To maintain good working practice • To obtain information for reporting purposes Some clients missed questions out and all were asked to comment or give additional information on some of the questions. On rating the counselling service overall:
19 said Excellent
6 said Very Good 3
The WEMHWBS forms were completed by clients at their first appointment, again in their last counselling session and a form was posted out 3 months after the last session. A low score would indicate poor mental health and well being and a higher score would demonstrate good mental health and well being. The lowest possible score is 14 and the highest is 70. An average score for most people not suffering from poor mental well being would be around 51. Results from forms completed over 18 months 2010-11
The scoring is based on average scores dividing the total scores by the number of clients. The graph demonstrates that clients attending their first appointment have a low score which increases dramatically by the end of their counselling. We were pleased that the people who returned forms after three months, showed that their score had continued to increase. The increased score was also evident in our last evaluation. “Counselling has helped me look at my issues far deeper than I had anticipated. I feel this has had better long term outcomes and benefits for me.�
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Clients are also asked to complete a ‘Flower Power’ sheet which is used by them during the counselling as a measure of how in control they feel of different situations. If the client wishes the wording can be changed on the individual petals to reflect their own situation. The numbering is 1– 5 with the higher score demonstrating more control.
KEY: PH – Physical Health FI – Finance EM – Emotions CS – Current Situation FU – Future RE – Relationships SN – Support Network AL – Activity/Leisure EMP – Employment ED – Education NE – Neighbourhood
The graph above is an example of the sheets completed by a client; most of the areas asked about did show improvement and the flower chart itself is an excellent visual aid for the client to see their own progression. “It has really helped my confidence and my understanding of myself.”
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CLIENT SATISFACTION QUESTIONNAIRES The first questions asked clients how they felt about being referred for counselling and also what they perceived as being their main issues. Clients were asked: What was your first reaction to being referred to the counsellor?
Most clients approached counselling with a positive attitude, but some did have anxieties.
“Very difficult at first, but Lucy was brilliant and considerate about issues that were sensitive to me. Gradually, I started doing things differently in my life, which have turned out to be
“The counsellor was very understanding and the staff at WHAC made you feel welcome”
very positive.”
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Example of main issues presented at 1st appointment
ISSUES KEY 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19.
Women’s Health Issues e.g. Menopause/PMT/Infertility Physical Health problems e.g. STD’s, Mastectomy Mental Health e.g. Stress Depression Abortion Bereavement/ Loss Relationship Problems e.g. Sexual issues/family/relationship breakdown. Drug/Alcohol issues Caring responsibilities Rape/sexual assault including harassment Child Sexual Abuse Domestic Violence – Physical violence/bullying Relatives/carers affected by abuse/trauma Self esteem/body image Work related issues Suicidal Financial Anger Management Eating Disorders Life Stages/Choices
This graph demonstrates some of the issues that are presented at assessment. Mental Health issues continue to be the main reason for women attending counselling. We do have a high proportion of women contacting us who experience domestic violence however, in many cases these women can’t or don’t want to be contacted for evaluation purposes for personal safety reasons. 7
We asked whether clients were offered anti depressants by their GP or were they on anti depressants before or during their counselling. 14 answered yes and were asked how they felt the counselling helped.
For many of the women, counselling offered an alternative to taking medication, but for others it added additional support to that gained by prescribed medication. “I firmly believe that had I not received counselling when I did my life would have spiralled out of control. The benefits for me were invaluable. Counselling I believe isn’t just for the individual it has ripple effects. When I entered my journey I had very low self esteem, it made me think seriously about myself in ways I wasn’t comfortable with at first. It is a true saying talking does help and a ‘problem shared’. My personal belief is medication isn’t the answer, yes in some cases it does help but that wasn’t the avenue I wished to follow. WHAC is and has been a lifeline to me and I’m sure to many women past and present and in the future. For this I am truly and eternally grateful, so saying this I say thank you from the bottom of my heart and keep up the good work.” 8
We asked clients about the waiting times. The first graph demonstrates how long clients waited for their first assessment appointment.
We are constantly striving to reduce waiting times for initial assessments and counselling. Many of the people who have waiting for longer periods have either had very rigid availability or have been offered several appointments. “The back office staff were wonderful, very supportive and L was fantastic when I just broke down one day – she supported me via the phone�
The second graph shows the waiting time for clients for their first counselling appointment following their assessment.
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Clients were asked whether they felt that the counsellor understood their problems and feelings. One indicates that the counsellor was very understanding and five indicates that the counsellor had no understanding.
“WHAC and my counsellor Lucy really helped me to see my problems in the past and looked towards the future very positively. I don’t feel anxious or unhappy, its completely the opposite. Feel as though I’m in control of my life.”
The graph below demonstrates how satisfied the clients were with the counselling they received. One indicates that the service was good.
Client satisfaction is marked very high, which reassures us of the high quality service WHAC provides to clients. 10
Following assessment clients are offered 6 sessions; these can be extended when necessary. Assessment and counselling sessions usually last for 1 hour. The average amount of sessions attended by clients over the past year is 8.
Clients were asked whether they felt that the number of sessions they had was adequate.
The majority felt that the number of sessions was just right. Sometimes clients feel they would like more sessions; it is agreed between the counsellor and client when it should end.
Made me realise I wasn’t alone, that all my doubts and insecurities were valid. Made me challenge my thought and actions, made me realise that I was important and my views and feelings counted
I was very impressed with the whole aspect of WHAC. Fiona knew just what to ask & I always felt sure of her confidentiality. I never felt judged but my thinking was challenged.
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CONCLUSION
This report helps to demonstrate the high standard of counselling support offered to clients at WHAC. This is achieved through the hard work and commitment from the staff and volunteers involved in delivering this service. We are grateful to the clients who have taken the time to complete questionnaires and value their comments immensely as there can be no greater affirmation that we are ‘getting it right’. We find the data from the Warwick Edinburgh Mental Health Well Being Scale invaluable in demonstrating the impact counselling can have on clients and gives us a way of showing these benefits for reporting purposes, but also to clients and volunteers as a way of measuring progress. The flower power chart is used mainly for clients to map their own progress, but is also used as a measure in the overall evaluation. We have addressed the waiting times, through the recruitment of 8 new counsellors who are starting to see clients from February 2012. We are fortunate to have the service of psychotherapy students the Northern Guild of Psychotherapy. They enhance WHAC’s counselling service and are able to see clients who need long term support . Appropriately the last word of this document should go to the clients that have accessed WHAC’s counselling service. “I honestly didn’t believe that counselling would benefit me – how wrong was I! From my first session I was overwhelmed at the difference I felt in the way I felt about myself.”
“A life changing experience. The past cannot be changed, but it certainly gave me the skills, knowledge and awareness to prevent negative things occurring again in the future.”
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