Counselling Evaluation
2013
The counselling provided at WHAC is a free, confidential service for women and girls 14+. During 2012 we have also started seeing male clients, though this has been on a limited basis until we acquire the funding to increase our capacity. 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.
Sample of Case Studies written during 2012 Case study one - Beth Beth came for 15 sessions to therapy with very low levels of self worth and confidence. She has struggled in life to maintain intimate relationships. She has not been in work for over 6 years. Beth has worked hard to make positive steps forward with her feelings of self worth, which were linked with her difficulty in forming intimate relationships. With these positive steps forward to build her own feelings of self worth, she has strengthened the relationships with her close family, including the relationships with her husband and daughter. A key point in this journey has been Beth’s ability to talk about the death of her son. I’m struck by Beth’s determination and foresight. Her negative outlook on life has begun to change and she has now been successful in securing full time employment in an administration role.
Case study two - Joyce Whilst working with Joyce, work was done on her experience of childhood Domestic Violence. We were able to make links between her childhood and her issue with alcohol. During the counselling sessions it became apparent that Joyce had feelings of guilt regarding the impact her drinking had on her son, the fact that he had witnessed her being arrested when she became drunk and violent. Joyce did a lot of work around her anger issues recognising that often what lay beneath the surface of her anger were feelings of low self-esteem/confidence. At the end of our counselling Joyce had virtually stopped drinking and had changed behaviour patterns becoming less volatile. Joyce recognised she had choices and could create a better future
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Clients real names not used
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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 2012 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 Jan-Dec 2012
The scoring is based on average scores dividing the totals 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. “A very positive & rewarding experience. It has helped me greatly. I can really cope and look at everyday challenges differently now (for the better) Thanks “
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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 showed improvement and the flower chart itself is an excellent visual aid for the client to see their own progression. Some may stay the same e.g. Employment, but if other areas improve it can help them be more ‘work ready’. “Counselling has helped me a lot. It helped me move forward and on to next step, knowing that I can do it and I can ask for help if or when needed.”
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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 as expected some did have anxieties. None had a problem with being sent to WHAC.
“I was made to feel welcome by all members at the WHAC. I will never forget how lovely and helpful my counsellor was. I would recommend WHAC services to anyone who could use your help. Thanks.”
“Very beneficial, WHAC offers a brilliant service. Talking to my counsellor was like talking to a friend.”
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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. There is also a high number who are or have been feeling suicidal as well as those experiencing bereavement and loss. 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.
The number, who claimed it helped them reduce or come off medication, has increased this year. In previous reports the result have been approximately 1/3 for each question. Many people find that counselling can be used as an alternative to anti depressants, but it does work alongside prescribed drugs and looking at the results from the Mental Health and Well Being Scale would indicate that the results continue after therapies have ended. “I feel that without the counselling and the warmth of the whole environment at WHAC I might have ended up in hospital or worse.”
“Confident expressing your problems. If I hadn’t accessed counselling I wouldn’t be where I am at now, feeling positive about my future.”
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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 waited for longer periods have either had very rigid availability or have been offered several appointments. The number of referrals is increasing and our capacity isn’t so it is possible that these waiting times will increase. “I am sure I could not have had more professional help. All the staff at WHAC have been supportive on the phone, administration and face to face.�
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.
“The experience was very good. I felt safe and that I could trust my counsellor. An excellent place.�
The graph below demonstrates how satisfied the clients were with the counselling they received. Number one indicates that the service was very satisfactory.
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 to 8 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.
“It helped greatly during a very difficult time and it was reassuring to know that I had an appointment each week to talk about things. If I ever need your services again I know you are there which is the most reassuring of all. Thank you.”
“The amount of work put into WHAC helping people, who needs it is very important. They are very reliable and take you through your sessions at your own pace.”
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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 have noted an increase in the number of clients under 18 years of age and have been looking into using a different evaluation method that is more ‘user friendly’ for them. We can demonstrate the impact counselling can have using the Warwick Edinburgh Mental Health Well Being Scale, but use the flower power chart and also case studies to help us back up this information. We are going to incorporate a question in the questionnaire that we send out to clients about whether they feel counselling has reduced the number of visits they make to GP surgeries; this isn’t data we’ve recorded in the past, but an issue we often get asked about. We addressed the waiting times by recruiting new volunteer counsellors early in the year and were able to offer clients immediate appointments. However, we experienced a 25% increase in referrals in the second part of the year, and due to financial constraints are unable to increase our capacity at present. We are fortunate to have the service of psychotherapy students from Northern Guild of Psychotherapy. They enhance WHAC’s counselling service and are able to see clients who need long term support. We also have a couple who are qualified to see young children and we have taken advantage of this to work with parents and children when appropriate. We work with other organisations to deliver counselling services, either as a partner e.g. SWAN project, Relate and also to ensure that the clients are signposted to the organisation that can best suit their needs.
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At present all our counsellors are qualified to a minimum of foundation degree level, and some of the psychotherapists who qualified whilst having a placement at WHAC, have chosen to continue working on a voluntary basis. The Counselling Co-ordinator ensures that all counsellors undergo regular training in specialised issues e.g. Domestic /Sexual violence, self harm and they also attend updating training in Safeguarding, note writing etc. Appropriately the last word of this document should go to the clients that have accessed WHAC’s counselling service. “I am very grateful to everybody at WHAC for all the help I have received and all the kindness I have been shown. When I returned to WHAC (I previously had help in 2007/08) I was very low, isolated and felt hopeless. WHAC was the one place that I could turn to and slowly, with your help, life has improved. Thank you so much.” “Daughter also seen at WHAC. Felt really let down by ‘authorities etc’, who were supposed to help. WHAC was a godsend. They have and are supporting us both with help we needed and didn’t/couldn’t get anywhere else! Such a valuable service and they didn’t give up till they found us the help we needed. “I was accompanied to an ESA tribunal by one of your counsellors. I was able to turn to you when there was no one else to help.”
“All your staff helped by giving me their respect, their warmth and were able to show in their appearance of how much they like their jobs.”
“First class, WHAC helped save my life.”
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