Charity No. 1119121
Company No. 5987640
Women’s Health Advice Centre (WHAC) has recently changed its name to Cygnus Support. Throughout this report we will refer to the organisation as Cygnus Support, however there may be quotes used that refer to WHAC as that was our name at the time the quote was given. The counselling provided at Cygnus Support 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 Cygnus Support 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@cygnussupport.com Lucy Greensmith (Counselling Co-ordinator) lucygreensmith@cygnussupport.com
Cygnus Support 2016 Counselling Evaluation Charity Number 1119121
Company Number 5987640
Who are the counsellors at Cygnus Support? Counselling at Cygnus Support is a vital service to the people who access it and is recognised as a quality service by those that refer people into it. The success of the service is attributable to the excellent skills of the counsellors themselves. The service is led by a Counselling Co-ordinator, who is involved in the recruitment and selection process as well as ensuring that the counsellors are appropriately supervised and supported in line with British Association of Counselling and Psychotherapy guidelines. The Co-ordinator is also our designated person for safeguarding within the organisation. We currently employ one paid counsellor, though are hoping to increase this number in the near future. This counsellors role involves carrying out assessments, triage and having their own clients. We have over 20 volunteer counsellors and psychotherapists who are often doing other paid work as well as their volunteering. We recruit people who are doing their foundation degree in counselling, so they can do a placement with us, but we are lucky in that several stay on as volunteers after qualifying. We have worked with the Northern Guild of Psychotherapy for many years now and are pleased to be able to offer placements to their very skilled trainee therapists. Some of these volunteers have also stayed on after qualifying which means that we can offer those clients that need it some long term therapy. All the volunteers receive regular training which supports their personal development with some issues being a requirement e.g. child protection and domestic abuse. Thank you to them all for their continued loyalty and commitment to the organisation and their clients.
Cygnus Support 2016 Counselling Evaluation Charity Number 1119121
Company Number 5987640
Sample of Case Studies written during 2015 Clients real names have not been used
Case study one – Sandra Sandra attended counselling at WHAC to help with processing unresolved early trauma, involving sexual abuse that she had suffered as a young child. She also wanted bereavement therapy to help with the loss of her mother, who died when she was three. Sandra had not spoken of the sexual abuse to anyone before. Therapy involved validating her experience and helping her come to terms with the consequences that this had on her life. The main difficulties for her involved lack of confidence, trust and also repeating the pattern of abusive relationships with her current partner, and father of her children. Because of Sandra’s difficulty in maintaining close relationships, she initially found it difficult to attend the sessions regularly. Flexibility around the regularity of the sessions was offered to her, to help her build trust and therefore help with processing the trauma. Because of the ability to maintain this flexible arrangement, she was able to gain more control, feel confident and pace her own therapy. Ultimately at the end of therapy, Sandra felt assertive, confident and demonstrated this in her choice to end the current abusive relationship and continue confidently in making her own life more positive for herself. She felt that she had processed the early sexual trauma and that this didn’t have a hold on her, in the same way that it did before therapy.
Case study two – Denise (Psychotherapy) Denise is a 35-40yr old who attended for 79 counselling sessions between 26.9.13 and 2.7.15 Denise presented with low mood, flashbacks, nightmares, poor sleep, loneliness and a feeling of isolation. She had recently been relocated from the South into a refuge and was separated from two of her four children. Her goal was to work through her emotions and to come to terms with her new life in the North East so that she could feel happy again. Our work covered her difficult childhood and young adulthood and traumatic events she had experienced during her life. She had been in a very violent relationship prior to being relocated and the perpetrator was in prison. She still loved this man and in the early months of our therapy, a lot of our work centred on the abuse she had suffered and her feelings towards him. Cygnus Support 2016 Counselling Evaluation Charity Number 1119121
Company Number 5987640
In 2014, Denise’s cousin went on trial for sexual abuse and Denise was the main witness. This was an extremely traumatic time for Denise and I stayed in daily contact with her during those weeks. Gradually, at the start of 2015, our work focussed more on Denise's suppressed anger. This was a turning point for the therapy and Denise started to report that she felt happier and more positive about the future. She decided that her home was in the North East and that she actually wanted to stay up here and make new friends and build a life for herself and her children. She had come to terms with elements of her past and the way her family treated her and had decided that she was different to her family and that she did not want to live near them anymore. We ended by mutual consent - Denise attended a follow up session in September following the death of her father, Despite the grief she was feeling, she reported that she still felt positive and happier in her life and that she no longer needed counselling.
Case Study Three - George George attended 7 sessions of face to face counselling in Ashington. George presented with anxiety, depression and panic disorder following from a past relationship with a partner and the death of his mother. George was struggling to come to terms with the abuse he had suffered during his relationship with his partner and her inappropriate behaviour towards her daughter. He was also very concerned over her attempting to obtain money from him which would result in him having to sell his home. During counselling George talked through his experiences and at the end of the process informed me that he felt he had now accepted the passing of his mother. Within session 7 George informed me that he had heard from the courts and his partner was withdrawing from trying to obtain money from him and was agreeable for a quick divorce. George informed me that he felt much more optimistic about his future and felt he had benefitted from counselling. He felt ready to end counselling and I informed him that he can self-refer again in the future should he feel he needs to. “It helped me to move on from where I was ‘stuck’. It was a real support in very difficult times. My counsellor was very effective at challenging some really unhealthy thoughts/habits.”
Cygnus Support 2016 Counselling Evaluation Charity Number 1119121
Company Number 5987640
CYGNUS SUPPORT’S COUNSELLING SERVICE During 2015 WHAC (Now Cygnus Support) saw 156 new clients for assessment. These clients were made up of 140 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, low self esteem, bereavement, domestic violence, sexual abuse, self-harm, suicidal thoughts and physical health problems. Often multiple issues have a debilitating impact on their lives and the lives of their family and friends. Cygnus Support provides a service, 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. 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.
“At first I was very nervous but felt relaxed within minutes. Talking to a stranger and not being judged was the thing I liked the most.” “Very supportive when I needed someone unbiased to turn to. Confidential, encouraging and friendly. Not judgemental.”
Cygnus Support 2016 Counselling Evaluation Charity Number 1119121
Company Number 5987640
Issues presented at 1st appointment in 2015 by 156 new clients 160 140 120 100 80 60 40 20 0 1
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ISSUES KEY 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19.
Physical Health Problems Enduring Mental Health Problems Mental Health e.g. Stress Depression Crisis Bereavement/ Loss Relationship Problems e.g. Sexual issues/family/relationship breakdown. Bullying Caring responsibilities Rape/sexual assault including harassment Child Sexual Abuse Domestic Violence – Physical violence/bullying Self Harm Confidence/Self esteem/body image Referral to other agencies (MARAC Safeguarding) Suicidal Intent Financial Housing Life Stages/Choices Criminal Offences
This graph demonstrates some of the issues that are presented at assessment. A large number of clients present with issues that affect their mental health and wellbeing, including domestic abuse and bereavement. 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. We currently have an arrangement with Northumberland Domestic Abuse Service where one of their practitioners is based with us and we provide counselling in their Hexham office. Cygnus Support 2016 Counselling Evaluation Charity Number 1119121
Company Number 5987640
EVALUATION We use a number of methods to evaluate the impact and the process of our counselling service. The information in this report is taken from data collected during 2015 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 50 forms and have had 30 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:
•
21 said Excellent
•
5 said Very Good
•
4 said Good
Cygnus Support 2016 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 2015
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 have learnt to ‘own my feelings’ and I no longer feel ashamed. Letting go has allowed me to move forward. The counsellling has enabled me to think more clearly, clear the fog in my head and make better choices.”
Cygnus Support 2016 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’.
“I was emotional going over multiple Post Traumatic Stress problems and felt safe knowing I was understood. My confidence to help and look after myself as well as others was massively raised. The tools used to help me prompted me to also resource some of my own. I now feel like I’m getting ‘me’ back and getting my life and sanity back and no longer a robotic zombie.”
Cygnus Support 2016 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 referred to WHAC. “Very helpful and beneficial. Good experience, lovely counsellor.”
“I understood why in some situations I was angry, anxious, no confidence (a lot relating from my past/new experiences I had been through with different people) It started to make sense.”
Cygnus Support 2016 Counselling Evaluation Charity Number 1119121
“I gained confidence to be able to speak about what happened to make me the way I was.”
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. 20 of the 30 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.
“Fantastic service without this support I would have been severely depressed for longer.”
“Excellent, my mental state improved greatly through the process. My counsellor listened to my wants and needs from the session and was very sensitive to the areas discussed and not discussed.”
“I need the support from my GP and WHAC”
Cygnus Support 2016 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. There have been longer waiting times during this year for first assessments due to staff sickness, however this is now starting to improve with the employment of a new counsellor.
10 8 6 4 2 0 1-2 Weeks
3-5 Weeks
6-8 Weeks
9-12 Weeks
13-24 Weeks
24+ Weeks
The second graph shows the waiting time for clients for their first counselling appointment following their assessment.
The first part of the year showed a longer waiting time, however due to the recruitment of more counsellors during the year this has greatly improved. People waiting longer periods usually have very limited availability or have been offered several appointments. “I did find it mentally tiring taking breaks between sessions helped. I’m much happier in myself and it gave me a fresh start I needed to live my life again.� Cygnus Support 2016 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.
The graph below demonstrates how satisfied the clients were with the counselling they received. Number one indicates that the service was very satisfactory.
Whilst client satisfaction is marked high it is important to mention that the few people who weren’t as satisfied stated that is was mainly due to wanting more sessions than they were offered. This has been partially addressed by adding another session at the beginning. “It helped to have someone to talk to. I wish it had been for a longer period of time.� This client chose to put her name on the evaluation form so we were able to contact her and she was offered and accepted some extra appointments. Cygnus Support 2016 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.
Too few
Just right
too many
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. We have added an extra session at the beginning so counsellors and client have more time to discuss the counselling contract.
“A huge thank you to everyone at WHAC, I wish you all the best in the future. I’d have no doubt in my mind that you could help if I required your services again.”
“Home office/settlement in the UK on the basis of domestic Violence. Supportive letter from WHAC was very helpful in my case. I have not enough words to tell how I am grateful for all the time and warmth I have received from my counsellor and other WHAC staff. Thank you very much for the help and support that you have done for me at the hard time in my life.”
Cygnus Support 2016 Counselling Evaluation Charity Number 1119121
Company Number 5987640
Clients were asked to say approximately how frequently they accessed their GP Service
“I found the counselling very helpful and cathartic, the emotional relief given from being encouraged to own ‘ones feelings’ i.e. not being afraid to admit being depressed and lost.”
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.” Cygnus Support 2016 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 our 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’. It also gives us the opportunity to make adjustments based on suggestions. An example of this is when clients in their feedback have said “Allow to have a periodic catch up in case an unearthed problem surfaces in the future.” And “Would have liked maybe a phone call to ask how I was doing and whether I needed any more sessions.” As a result we plan to ask clients if they would like a follow up and implement this into our working practice. 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. Our triage system, has 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. Due to staffing issues the waiting time for clients increased, this was also affected due to delays in being able to run a new counsellor recruitment. The staffing situation is now back to what it was previously and we are planning to expand this service with the employment of more paid counsellors so we can reach clients in other parts of the county. We work with other organisations to deliver counselling services, either as a partner e.g. Lighthouse project, 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 tightened up our recording systems to make them more efficient and streamlined, ensuring that we are not keeping any unnecessary or duplicated information.
Cygnus Support 2016 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. “My visits to WHAC helped me understand the feelings I was having about the situation I was in. Gave me more control over my emotions.”
“WHAC and the counsellor helped me to gain confidence in myself to leave an abusive marriage. I was helped to access benefits and Women’s refuge. If it wasn’t for WHAC and women who run it I would not be here today, so I am immensely grateful to them all.”
“I was informed of local charitable organisations and suggested places like Age UK, Samaritans etc. I cannot praise and be more thankful for the service I have received from WHAC from entering the building to exiting, I was treated with courtesy and understanding. My counsellor was a godsend and I’m forever grateful to her for everything we worked together to achieve and to be in a much better place in my life.”
“An amazing service, I don’t like to think what would have been if the counselling wasn’t available. My counsellor was sensitive supportive and obviously an incredible listener. Made things a lot clearer to me by asking simple questions. Thank you so much.”
“Very helpful, satisfaction knowing when coming, you’d get fantastic support and felt fine when leaving. Invited to attend classes of relaxation advised to see doctor when I had concerns about stuff. I would definitely recommend this service to anyone in a desperate situation, they are very understanding and very helpful and talk you through stages to help you out.”
“Brilliant organisation.”
Cygnus Support 2016 Counselling Evaluation Charity Number 1119121
Company Number 5987640
1 Council Road Ashington Northumberland NE63 8RZ Tel: 01670 853977 www.cygnussupport.com E Mail: counselling@cygnussupport.com
Opening Hours Monday-Thursday 9.00am - 5.00pm Friday 9.00am – 4.30pm Evening appointments Available
Charity No. 1119121
Company No. 5987640