2015 Annual report of DMU Counselling and Wellbeing: Student and Academic Services Directorate

1) Impact of counselling on academic outcomes and student feedback

The CIAO measure (Clinical Impact on Academic Outcomes) looks at retention, achievement and the student experience at the start and end of counselling. The charts below show very positive changes (in part due to the impact of counselling) supported by an additional question specifically about counselling. Numbers completing (n) is shown on the charts. In total 461 students completed the pre counselling measure and 276 completed the post measure (60%). We will seek to increase this post percentage to 80% next year, but the figures do show a significant change for the better!

a) Retention

73% of students considered counselling to have helped them to stay at university. The graph below also shows pre and post counselling retention figures. Improvement may be due to several factors, but counselling encourages students to take positive actions including seeking more support from others (tutors, friends etc).

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b) Achievement

75% of students considered counselling to have helped them do better in their academic work. Pre and post counselling figures are shown below.

c) Student experience

84% of students considered counselling to have improved their overall experience of being at university. Pre and post counselling figures are also shown below.

The majority of students (87% plus) also said that counselling helped them to develop life skills, improved their self-esteem and helped them feel more positive about the future. This is backed up by some sample quotes (given with student permission).

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I have no doubt that your counselling was pivotal in letting me meet my full potential; without all the doubt, worry, anxiety and the black thoughts holding me back I was able to fully focus all of my energy on my studies and achieve everything I have. Before I came to see you I had hit rock bottom and was seriously considering giving up the course and going back to work, but I can see that would have been the wrong choice to make.

I must also commend my tutors for encouraging me to come and see you and to not be afraid that I would be judged or that my problems were not real. The quality of pastoral care at DMU is fantastic, please don’t ever stop doing what you do, I am sure there are others like me and without your help their potential will be wasted. If there is anything I can ever do to help your department, you have only to ask and I will do everything within my power to make it happen.

I recently had counselling with Ben, and just wanted to say a massive thank you, talking to someone really helped and I'm extremely grateful for all the help and support!

2) Follow up survey

For the third year running one of our counsellors (Chris) has carried out a follow up survey (‘Survey Monkey’) of students. This was carried around two months after completion of counselling. This is very rich information as students provide very open and honest feedback. A report is available, but here are some highlights.

a) 114 students completed the survey out of 294 contacted (39% down from 44% last year, but still a very good return).

b) The main way students find out about us is via our website (41%).c) The majority of students found counselling to be supportive and helpful

(87%). Most would recommend counselling to a friend or return if they needed further help (91%).

d) 11 students were not happy with the counsellor or counselling (10%).e) The majority of student ended counselling at a point when they felt better

(63%). However a significant number commented that counselling finished because they had all the sessions that could be offered (40% up significantly from 21% the previous year) and 15% felt counselling could not help with their concerns.

f) Linked to this the majority of students (78%) had six sessions or less. Of the 42 students who said they had all the sessions that could be offered only 8 had up to the maximum of 10-12 sessions so potentially could have had more. Note: Although it may have been therapeutic for some of these students to have been offered more sessions, there have been practical/timing issues that made this impossible.

g) ACTION: 1) Counsellors will receive feedback on the comments of the unhappy students with a view to reflecting and considering action points

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arising. 2) The option of students switching counsellor (different gender, therapeutic approach) will be reinforced both in initial appointments and on our website (appointments and making contact). 3) Reinforce the message to counsellors that six sessions is not a strict limit and can be extended if therapeutic to do so.

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3) Some key performance measures for counselling

Measure 2015 2014 TargetWaiting times from referral to initial counselling appointmentn=735

13.9 days 12.4 days 15 days

Attended sessionsn=735

84% 83% 80%

Planned endingsn=564

81% (includes single sessions)

75% 80%

Pre and post outcome measures collectedn=371 out of a possible 469

79% (of clients who completed a course of counselling)

81% 80%

Improvement ratesn=371

67% 75% 80%

Notes

1) Referrals are on an upward trend in common with other universities. We have had 735 referrals roughly the same as last year, but greatly increased from 2010/11 when we started doing annual report and the figure was 497 - an increase of close to 50% in five years. Of these 609 students actually attended appointments indicating some students may not have been ready for counselling despite applying. The referral increase reflects a national trend of increasing demand for counselling in universities. The main reasons are that more students are struggling to cope with the demands of life, there is an increased awareness of counselling and there have been an increase in referrals from GP’s possibly reflecting NHS changes. One in six referrals (113) was from the NHS and one in five was from academics. By referral we mean that all students self-refer, but were signposted to do so by others in the majority of cases.

2) A noticeable trend in the last couple of years is the greater number of students presenting with anxiety issues who struggle to cope with the demands of life and study and sometimes lack emotional resilience. There is a need to respond to this in a holistic way and not just through one to one counselling (for example self-help information and emotional resilience workshops).

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3) We have had an increase in e counselling usage this year (counselling by e-mail exchange) although numbers are low. We had 13 clients up from 7 the year before.

4) Demand has also increased for coaching (life skill development) with 56 clients up from 33 the previous year. Having a separate website has helped to give coaching a distinctive identity.

5) As demand has increased so have waiting times which are just under the 15 day average target. At busy times the average wait is around three weeks. Most students are okay about this, but students wanting earlier interventions are referred to the mental health inclusion team and/or their GP if urgent.

6) Attendance rates of 84% are pleasing and the introduction of MyGateway may have helped as email appointment reminders are sent the day before.

7) A total of 468 students had a course of counselling (more than one appointment). We obtained a post outcome measure for 4 in 5 of these students which is a good return. Of these 67% of students showed improvements in functioning and wellbeing and reductions in problems and risk. Of the 33% ‘no change’ clients, 5% were in the ‘healthy’ population to start with and were unlikely to show ‘statistical’ improvement and nearly 2% deteriorated. Counselling can still be of benefit in these cases, for instance in helping to increase self-esteem and in the academic outcomes area reported on earlier. In the therapy field 67% is a good improvement rate, but is down on last year which is disappointing. It is hard to know why this is apart from commenting on the complexity of some of the student presentations which can mean that improvements in functioning are not easy to achieve in the short-term. It could also link to the increase in the number of students who indicated a wish for more sessions. This will be discussed as a team to see if there are any learning points.

Statistical improvement rates n=371

ImprovementNo Change

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8) The average number of sessions was 4.9) A sample CORE graph is shown in the Appendix.

4) Self helpa) The Living Life to the Full programme (e books and videos on a wide range of

physical and mental health topics) has been made available on smart phones as well as computers. Some hard copy examples are shown below. In the last 12 months we have had 1200 hits.

b) We also have a downloadable program called the Natural Relaxation Package (a combination of voice and music) which helps relaxation or recharging your batteries! In the last 12 months this has had over 1400 hits.

5) Equality Impact 30% of our clients are male (it was 25% last year, but is always in the 25 to 30% range). This is lower than the DMU population of males, but is a pleasing increase. There have been more referrals from the Technology faculty this year and it is possible that workshops offered to students (such as resilience) has led to some pick up in referrals for one to one support.

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Coun-selling

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Around 70% of our referrals were ethnically white compared to 55% of the DMU undergraduate population. We are using other methods to reach out to males, BME and international students such as workshop delivery.

6) Counselling contribution to the wider university

The team are increasingly being asked to contribute to projects, workshops and training events in faculties, the library, with other SAAS teams etc. We are very pleased that we are able to use our knowledge and skills in this way. Examples include contributions to the CLaSS study support workshops, PHD support programmes and faculty requests for coaching workshops. We continue to run the training event ‘Helping Students in Distress’ for staff in conjunction with the Mental Health Inclusion Manager.

We carry out staff feedback surveys which show that this work is highly valued and there have been some helpful suggestions such as a visual flow chart on our website so students can see the range of services we provide more clearly.

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7) Plans for 2015/16

a) The core team are linked to faculties as followsTrevor Butlin: Line and risk management plus Business and Law faculty link and SU link.Mark Evans: Development of coaching (workshops, one to one work and website) and HLS faculty link. Susie Ward: Wellbeing projects and resources, MotiMate exercise programme in conjunction with the Leisure Centre, faculty link for ADH.Carol Dawson: New counsellor –welcome. Lead areas to be developed such as reaching out to students who are under-represented in using welfare services and faculty link for Technology.

b) We are pleased to welcome four new volunteer (associate) counsellors making six in total. They are Sharon Bennett, Fiona Lamrani, Wendy Padley and Louise Gamble.

c) We continue to extend the range of workshops we offer through CLaSS. New ones include emotional resilience and perfectionism.

d) We are increasing our contribution to the mindfulness programme for students and staff.

e) There will be an extension of the coaching support/training we offer to staff in order to assist them in the ‘pastoral’ support offered to students. For example a student welfare team project to contribute to the Personal Tutor workshop programme via Abigail Moriarty. This will contribute to the new university student experience strategy.

f) We are reapplying for professional service accreditation which we need to do very five years and this report forms part of that process.

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Figure 1: Appendix

This sample CORE graph shows a reduction in problems over the course of counselling illustrated by the blue line. Anything below the horizontal blue dotted line is healthy functioning. The red line shows a reduction in risk and anything below the horizontal red dotted line is a ‘healthy’ level of risk. The problem levels are shown on the left of the graph and the CORE 10 questions (the shorter version of CORE 34 for quick use) shown above. Reliable (statistical) Improvement is measured as a drop of 5 points or more on the left hand axis.

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