Celebrating 30 years of delivering services in Northumberland
Counselling Evaluation
2014
WHAC celebrates its 30th year WHAC’s official opening took place in May 1984. In the first three years, WHAC organised two health fairs and started running courses and support groups. Margaret Marks started her relaxation sessions. Courses were very popular; one assertiveness course was so well attended we had to move into alternative offices for the extra space. Annual attendance at the centre was around 600, and 50% of the counselling took place over the phone. There was an emphasis on providing practical help and information on health issues like PMT and menopause and clients usually had no more than one or two “listening” sessions. Throughout the 1990s WHAC began to evolve into the organisation we know today. The pattern of counselling changed to more long term work, more referrals from the statutory sector and counsellors were more thoroughly trained and selected and undertook specialised training in areas such as rape and child abuse. In 1993 a robust system of keeping statistics was introduced. External supervision for counsellors and a system of initial assessments were introduced the following year. It all began to feel a lot more streamlined, business-like and efficient. WHAC started offering services to girls as young as 14 in early 2000. They came with problems such as low self esteem and lack of confidence as well as issues of sexual abuse, self harm and bereavement. An extensive external evaluation was carried out in 2011. Some of the recommendations from it included: • A service for men & boys • More focused work with young people • Outreach counselling & support • Focused work on Domestic & Sexual violence WHAC’s constitution was changed in 2012 to include work with men and boys. This is carried out in outreach premises around Northumberland. The WHAC centre remains a woman only space. We now can show that 80% of our work is around domestic & sexual violence and we are working towards increasing the services we provide to young people. WHAC’s continued presence provides a safety net for those clients who may need periodic support or who suffer from crises and require intermittent support. Everyone at WHAC looks forward to continuing to offer its unique support and advice services to people in Northumberland. “It was a comfort to know that even though I had completed my counselling, I am able to contact the service again if I feel I need to”.
Sample of Case Studies written during 2013 Clients real names have not been used
Case study one - Mary Mary initially presented with problems related to her father’s drinking and work issues. Through the counselling she was able to disclose and explore many other events which she felt had impacted her, including abuse as a child, her parent’s divorce and a very chaotic and disrupted childhood. Mary had very low self esteem; she was always very hard on herself and suffered bouts of depression. Mary engaged fully in counselling, always eager to learn more about herself and understand what motivates her. Mary’s confidence began to build through the sessions and she began to value and like herself. She developed an awareness of her process and motivations, and the parts of herself, she didn’t like as much she began to try and accept. She decided to end counselling as she felt she had come as far as she could for now and wanted to consolidate what she had learnt and try on her own to put into practice the coping strategies and other things she’d learnt.
Case study two - Joy Joy returned as a result of experiencing panic attacks. Whilst working together she disclosed a sexual assault and with the support of WHAC staff she felt able to report the incident to the police. After reporting the incident the client said the panic attacks had stopped and even if the perpetrator was not prosecuted, it gave her some closure and control of her life. We also worked on family relationships and addressed her housing and benefit issues. WHAC supported her with both of these issues. When counselling ended the client had secured a home, full time employment, got engaged and established a healthy relationship with her mum, something that had been non-existing for a number of years. Client felt she had grown as a person and was able to look at relationships from a mature point of view. “Amazing! I really connected with my counsellor and she really heard me. I was astounded at the outcome and progress in my life after counselling.”
Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
The counselling provided at WHAC is a free, confidential service for women and men 14+. Women can be seen in our women only Centre or as outreach clients. Men are seen in a property we rent nearby and at other outreach venues in Northumberland. Thank you to all the staff, board members 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. If you would like to know more about our counselling service, or would like to make a donation to the Centre please contact: Cath Hale (Manager) cathhale@whac.uk.com Linda-Jaine Clair (Counselling Co ordinator) linda-jaineclair@whac.uk.com
Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
WHAC’S COUNSELLING SERVICE During 2013 WHAC saw 150 new clients for assessment. These clients were made up of 134 Females and 16 males. Not all will have started their counselling in this year as there would have been clients being seen from the previous year. Most clients were seen for 6-8 sessions. Many people have lifestyle or issue based problems, which lead to poor health and they require emotional and/or practical support to address these problems. People self-refer or are referred through partner organisations. Issues presented can include: mental health and anxiety, relationship problems, low self esteem, bereavement, domestic violence, sexual abuse, suicidal thoughts and physical health problems. Often multiple issues have a debilitating impact on their lives and the lives of their family and friends. WHAC provides support, which caters for individual needs, based on an assessment identifying the services or interventions, which would be of most benefit, i.e. counselling, psychotherapy, one to one practical support, or a combination of these. Services are delivered by trained/qualified volunteers, supported by paid staff. There is a robust system of selection and recruitment for volunteers who deliver most of the services to clients.We have a dedicated team of qualified counsellors and psychotherapists who receive additional NCFE accredited training and are governed by British Association for Counselling and Psychotherapy Standards. Assessments determine the appropriate counselling model to follow and sessions are offered. Psychotherapy is offered to clients requiring longer term therapies for more entrenched issues. We aim to address and reduce inequalities so people experience and benefit from: improved health and well being, becoming work ready, relief from depression and anxiety, overcoming trauma and reduced isolation and loneliness. HOW ARE THE COUNSELLORS MANAGED AND SUPPORTED Our Counselling Co ordinator Linda-Jaine Clair is also our Child Protection Officer and ensures that staff and volunteers are kept up to date with current legislation. All staff are line managed and receive regular supervision and support. Counsellors receive supervision from qualified counselling supervisors and also attend a 6 weekly group supervision. 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. “Experiencing how it might feel for a client to reveal their secret. It is sometimes easy to forget how difficult things may be for clients.” (Counsellor) “The whole topic or subject was approached and directed sensitively and accurately. “ (Counsellor) Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
Issues presented at 1st appointment in 2013 by 150 New clients
ISSUES KEY 1. Women’s Health Issues e.g. Menopause/PMT/Infertility 2. Physical Health problems e.g. STD’s, Mastectomy 3. Mental Health e.g. Stress Depression 4. Abortion 5. Bereavement/ Loss 6. Relationship Problems e.g. Sexual issues/family/relationship breakdown. 7. Drug/Alcohol issues 8. Caring responsibilities 9. Rape/sexual assault including harassment 10. Child Sexual Abuse 11. Domestic Violence – Physical violence/bullying 12. Relatives/carers affected by abuse/trauma 13. Self esteem/body image 14. Work related issues 15. Suicidal 16. Financial 17. Anger Management 18. Eating Disorders 19. Life Stages/Choices This graph demonstrates some of the issues that are presented at assessment. We have seen the biggest increase in clients presenting with Physical health problems, Bereavement/loss, Caring Responsibilities, Domestic Violence, Self Esteem and Work related issues. Most clients will present with several issues and we frequently work with partner agencies to offer a holistic service to the clients who use our services. Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
EVALUATION 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 2013 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 health and wellbeing 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 had 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 64 forms and have had 45 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:
•
35 said Excellent
•
8 said Very Good
•
2 said Good
Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
WARWICK EDINBURGH MENTAL HEALTH WELL BEING SCALE •
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 2013
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 been maintained.
“I am very grateful to have been able to access this counselling service. It has made a great difference to me as a person and for the first time in ages I feel more positive about the future. Something I did not expect to feel”
Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
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’.
“The two paper based assessments done at the start of the sessions really helped, was especially good to review them at the last session to see visual progress”
Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
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 didn’t trust other agencies – statutory providers have been unhelpful to me”
“When I first went for counselling I was very unsure and very mixed up; also didn’t know who I was or wanted to be. My counsellor listened to me and helped me believe in myself and become a stronger person. Thank you”
“Staff at WHAC very friendly. Make you feel welcome and at ease.”
Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
We asked whether clients were offered anti depressants by their GP or if they were on anti depressants before or during their counselling. 34 of the 45 clients who completed forms answered yes and were asked how they felt the counselling helped.
We do not necessarily view counselling 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.
“Counselling was the one bright outlook at a very depressing time. It was more than beneficial to me.”
“My GP only offered medication for my depression. I was referred by Job Centre to WHAC. I was at my lowest ebb not knowing where else to turn to. Their help was invaluable. Years previously I had been offered counselling by my past workplace which I found interfering and it caused me more angst than help so I did not expect WHAC to do any better, but their service and help were amazing. I cannot praise them enough. I will gladly promote them to others in future and I also intend to take up on other services they offer in future.”
Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
We asked clients about the waiting times. The first graph demonstrates how long clients waited for their first assessment appointment. In last year’s report only 20% of people were seen within 1-2 weeks following referral. In 2013 we have improved this by seeing 60% of clients with 1-2 weeks. A 300% improvement .
The second graph shows the waiting time for clients for their first counselling appointment following their assessment.
The number being seen 1-2 weeks after their assessment has also increased to 60% from 48% the previous year. People waiting longer periods usually have very limited availability or have been offered several appointments. “Glad I attended as I now can accept why I behave the way I do. Counsellor was very helpful in making me feel welcome and ‘normal’.” Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
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.
“My counsellor has been exceptional, her ability to gauge my feelings and her understanding of me was essential for the progress I made. I have never been in such a dark place but my time with her was enlightening on many levels and really did save my life. I cannot praise her enough.� 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. Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
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 usually agreed between the counsellor and client when it should end.
“I requested counselling as a hopeful solution to a long term emotional problem due to a very specific incident. Although my wait was long, the process was very supportive. I do not believe my issues are resolved, however I do feel more able to cope. For that reduction in emotional impact, I will always be extremely grateful.”
“Counselling has helped me so much to understand myself and I feel much more confident and am aware of my feelings and how to deal with them. Thanks to my understanding counsellor who was non judgemental & a very good listener.”
Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
Clients were asked to say approximately how frequently they accessed their GP Service
“The discretion and care from my counsellor was amazing. Seeing the same person each time helped enormously. I felt I trusted her implicitly and I was filled with confidence.”
We asked whether counselling at WHAC had affected the frequency the accessed their GP service
“I used to visit my GP every 3-6 weeks; I now go about every 3 months.”
Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
CONCLUSION This report is one of the most important documents we produce as most of the information in it is the words and feedback we have received from the clients. who have accessed WHAC’s counselling service, in their own words. The positive feedback demonstrates the high standard of counselling and support offered to clients. 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 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. During 2013 we set up a triage system, which seems to be having a very positive impact on client’s attendance at first appointments. It gives us the opportunity to be able to explain what happens next when a client is referred. We will be able to evidence the impact of the traige in next year’s report. We were very pleased to note the reduction in client waiting times that have been achieved this year. This is a credit to the staff and volunteers who worked tirelessly to ensure that clients were seen during a period when WHAC was at risk of closure. 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. 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 psychotherapists who are qualified to see young children and we have taken advantage of this to work with parents and children when appropriate. We have recently changed the way we record the issues presented. The new method will allow us to drill down the information much easier. It allows us to look at the physical issues being presented in more detail; as well as whether incidents have been reported to the police. Due to a successful Big Lottery Bid, we are very pleased to be able to recruit up to 8 new counsellors in 2014. They will be from a range of backgrounds and available to work around the county.
Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
Appropriately the last word of this document should go to the clients that have accessed WHAC’s counselling service and who have taken the time to complete the evaluation forms we send out to them. “WHAC helped me recover and come to terms with what had happened to me. Please pass on my everlasting thanks to my counsellor for helping me to mend the breaks”
“I was heard, understood, able to open up and for the first time able to express myself. I ended up feeling like a whole person again. I felt more than able to cope again and comforted that the door was still open for me.”
“Felt able to voice things I hadn’t to anyone else. Not judged, helped me explore my situation.”
“I felt very comfortable at WHAC, my counsellor was lovely. I never felt judged, pitied or anything negative; she helped me to see things clearly and to draw on my strengths. I certainly would not be where I am now without her.”
“The staff were really good, and very helpful, made me feel very welcome.”
“WHAC is a fantastic service that offered me a chance to get my life on track. My counsellor was amazing and enabled me to understand my problems and make sense of them. THANK YOU.”
“I cannot put it into words how I feel. All I can say is thank you so much. I’m living again.”
Women’s Health Advice Centre 2014 Counselling Evaluation Charity Number 1119121 Company Number 5987640
1 Council Road Ashington Northumberland NE63 8RZ Tel: 01670 853977 www.whac-online.co.uk E-mail: counselling@whac.uk.com
Northumberland Support & Advice Service Tel: 01670 858984
www.nsas-ne.co.uk Opening Hours Monday-Thursday 9.00am-5.00pm Friday 9.00am-4.30pm Evening appointments available
Company No: 5987640
Charity No: 1119121