Evaluation of long-term counselling at a community health service for women who are on a low income

Abstract

Aims: Given the lack of research evaluating long-term counselling, coupled with the lack of women-only counselling services, the present study evaluated the long-term counselling service offered by a women-only community health centre. Method: The research ascertained: (1) the characteristics of 155 service users pre-counselling, (2) the views and experiences of 75 service users post-counselling, and (3) pre–post-counselling clinical change in 98 service users via the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM). Results: Unemployment, low income and reports of abuse were related to poorer mental health as measured by the CORE-OM. Content analysis of open-ended questions revealed that women felt supported, comfortable and gained insight through the counselling relationship. They also reported positive changes in their lives, relationships, health behaviours, and psychological wellbeing. Post-counselling improvements were found in CORE-OM scores. Conclusions: Long-term counselling in a women-only environment for socially disempowered women may be beneficial. A research-informed approach to counselling and therapy evaluation, which acknowledges the social context of psychological distress, should be taken across institutions.

Keywords:

• abuse
• CORE-OM
• long-term counselling
• low income
• women

Acknowledgements

We would like to thank all of our participants, and all of those who work at the women's centre. We gratefully acknowledge the financial support of Middlesex University and the King's Fund.

Additional information

Notes on contributors

Nicola Payne

Biographies

Nicky Payne PhD CPsychol, is a Health Psychologist and Principal Lecturer in Psychology at Middlesex University. She completed a PhD in occupational health psychology at the University of Hertfordshire, and has run the MSc Health Psychology at Middlesex for nearly ten years. Her primary research interests are stress, work-life balance, health behaviours, health behaviour change and women's health.

Karen Ciclitira

Karen Ciclitira PhD CPsychol, is a Psychoanalytic Psychotherapist and a Principal Lecturer in Psychology at Middlesex University. She teaches qualitative research methods and clinical psychology. Her research interests include clinical outcomes, gender, psychoanalysis, racism, sexuality, health and qualitative research. Her recent academic publications include: Ciclitira, K., & Foster, N. (2012). Attention to culture and diversity in psychoanalytic clinical trainings. British Journal of Psychotherapy, 28(3), 353–373; Ciclitira, K., Starr, F., Marzano, L., Brunswick, N., & Costa, A. (2012). Women Counsellors’ experience of personal therapy: A thematic analysis. Counselling and Psychotherapy Research, 12(2), 136–145.

Fiona Starr

Fiona Starr CPsychol, is a Consultant Clinical Psychologist and Principal Lecturer in Psychology at Middlesex University. She teaches mental health, counselling and therapy and research methods. Her research interests include clinical outcomes, clinical supervision, experiences of counselling and therapy and qualitative research. Her recent academic publications include: Starr, F., & Ciclitira, K. (2012). Psychologists in independent practice. A contemporary portrait of psychologists in the independent sector. Report for the British Psychological Society. Starr, F. et al. (2012). Comfort and challenge: A qualitative analysis of counsellor's experiences of supervision. Psychology and Psychotherapy: Theory Research and Practice, 12(2), 136–145.

Lisa Marzano

Lisa Marzano PhD is a Lecturer in Psychology at Middlesex University. Her research interests include suicide and self-harm in clinical and forensic settings, experiences of counselling and therapy, and qualitative and visual methodologies.

Nicola Brunswick

Nicola Brunswick PhD, is a Principal Lecturer in Psychology at Middlesex University. She studied for her PhD in the psychophysiology of dyslexia at the University of Warwick and completed her post-doctoral training at the Wellcome Department of Imaging Neuroscience (UCL), the MRC Cognitive Development Unit (London), and the Department of Epidemiology and Public Health (UCL Medical School).