Estimating effectiveness of school-based counselling: using data from controlled trials to predict improvement over non-intervention change

Mick Cooper, Andrew J.B. Fugard, Jo Pybis, Katherine McArthur, Peter Pearce

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
62 Downloads (Pure)


Background: There is a growing body of data to show that participation in school-based counselling is associated with significant reductions in psychological distress. However, this cannot be taken as evidence that school-based counselling is effective, as improvements may have happened without the intervention. Aims: The purpose of this study was to develop a method of estimating the amount of ‘natural’ change that might be expected in young people who would attend school-based counselling, such that the effects of the intervention over and above this amount could be identified. Method: Young Person's CORE (YP-CORE) scores from 74 participants allocated to waiting list control conditions in four pilot trials of school-based counselling in the UK were re-analysed using regression models, and a formula was found for estimating the outcomes for young people were they not to receive counselling. This was termed their Estimated Non-intervention Outcome (ENO), and could then be compared against the young person's Actual Outcome (AO), to give an estimated intervention effect (EIE). Results: The formula for the ENO was 4.17 + 0.64 × baseline score. Using this, we calculated a mean EIE for 256 young people in a cohort evaluation study of school-based counselling, which showed that the counselling was associated with large and significantly greater change than would be expected without the intervention (Cohen's d = 0.91). Discussion: The method presented in this paper is a simple means for improving the accuracy of estimations of treatment effectiveness, helping to adjust for changes due to spontaneous recovery and other non-treatment effects.
Original languageEnglish
Pages (from-to)262-273
Number of pages12
JournalCounselling and Psychotherapy Research
Issue number4
Early online date14 Jan 2015
Publication statusPublished - 31 Dec 2015


  • adolescent psychotherapy
  • psychotherapeutic outcomes
  • practice-based research network
  • school counselling
  • psychological distress
  • interventions
  • treatment effectiveness


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