the role of psychological counselling in rethinking

THE ROLE OF PSYCHOLOGICAL

COUNSELLING IN RETHINKING

EDUCATION

2.14 Professional Section PSYCHE Opening Event:

Chair: Eric Depreeuw, Belgium

Speaker: Ann Conlon, King’s College London,

United Kingdom

Eva Egger-Zeidner, Psychologische

Studentenberatung Graz, Austria

Hans-Werner Rückert, Freie Universität

Berlin, Germany

Hans-Werner Rückert Freie Universität Berlin EAIE Conference Dublin | 15.09.2012

Professional Section PSYCHE

• PSYCHE provides a forum for all those involved in

guidance and counselling of students in higher education

within Europe. PSYCHE encompasses elements of the

former Special Interest Group, FEDORA, which was

dissolved in 2012. Professionals in the field of guidance

and counselling for both domestic and international

students are invited to join PSYCHE


Agenda

• Student‘s mental health worldwide

• Identity development and psychological

counseling

• International Students

• Good practice examples from the United

Kingdom, Austria and Germany



Mental Health Statistics:12 month prevalence rates

Any disorder %

Population USA 2005 32,4

Students USA 2008 15%

Population EU 2004 35,0

Adolescents EU 2003-2008 9,5-22%

Students Germany 2006 11%


Depression

Students USA 1938 1% scored in MMPI

Students USA 2007 6% scored in MMPI

Students USA 2002 10% diagnosed as depressed

Students USA 2002 38% feeling depressed

Students USA 2004 45% feeling depressed

Students Germany 2007 16 – 23 % feeling depressed

Students Poland 2008 34% feeling depressed

Students Bulgaria 2008 39% feeling depressed


USA

• National Survey of Counseling Center Directors 2010

10,8% of the student population seek help (international students to a lesser extent)

91% see a continuation of the trend towards more severe problems

(6 suicides at Cornell in 6 months 2009/2010;

2008 WHO report: 50% of the students contemplated suicide vs. 15%

in general population;

massacre at Virginia Tech., Alabama 2007)

• Not to mention China...


STRESS

Students Sweden 2007 52% stresssed

Students Sweden 2010 70% stressed

Students Austria 2009 61% stressed

Students USA 2008 85% stressed


Developmental task of postadolescence

•Positive development

– Goal attendance

– Personal Growth

– Flexible identity conceptions with adaquete ego-strength and frustration tolerance

•Negative development

– Shortened identity development

– Pseudo- identity

– Identity diffusion


Developmental task of postadolescence. Identity formation

•Negative development

Biografical vulnerability

Lack of coping skills

Burdens from study situations

Anonymity

Pressure for achievement

Examination pressures

Financial problems

International Students

Culture shock

Loneliness

Homesickness

Language proficiency

Isolation

Expectations from

home Hans-Werner Rückert Freie Universität Berlin EAIE Conference Dublin | 15.09.2012


Underutilize

Psychological

Counselling Services

Expect problem- (and

not emotion-) oriented

support



Germany

11,4% international students (FU Berlin: 18%)

13 % from China

5,4% from Russia

…Poland, Bulgaria, Turkey

46% undergraduate drop-outs (compared to 28% domestic students

23% Chinese student‘s drop-out rate

68% African student‘s drop-out rate


What more to do? In general:

Developing a mental health and learning support policy

• Training and awareness raising strategies

• Networking with other Student Service/Support agencies, university administration, program and curricula developers etc.

• Engage in team-teaching with faculty

• Integrate counseling aspects in teaching

• Integrate counseling aspects into training of faculty

• Feed back to Academic Senat, University Administration,

Presidency


Good practice: Multicultural Concept of Counseling (Jacobs University Bremen):

Multicultural competencies of the counsellors

Inclusion: Welcome event for incoming students

Awareness weeks

Community involvement

Lowering the threshold for counselling, e.g.:

Train tutors for dormitories (Studentenwerk U Oldenburg)

Work-Life Balance workshops (U Braunschweig)

What to do? Specifically:

ISFU



[email protected]

Thank you for your time and attention!


COUNSELLING IN RETHINKING

EDUCATION

2.14 Mental Health and Learning Support Strategies

Background to the current situation in the UK:

Significant changes to HE since 1960s include

•1995 – the Disability Discrimination Act – HE Institutions have a ‘Duty of Care’ to respond to mental health in student by making adjustments in the study environment to account for disabilities •2001 Special Education Needs and Discrimination Act – Disabled Students should not be substantially disadvantaged (particularly financially) in comparison to those who are not.

Ann Conlon King‘s College London

• 1997 – National Committee of Enquiry into HE introduced the concept of Widening Participation to encourage those students from socioeconomic backgrounds to enter HE. For example, KCL has introduced an Access to Medicine Course, an Enhanced Support Dentistry programme and a K+ Scheme aimed at disadvantaged youngsters.

As a result: • Enormous changes in the demographic characteristics of students, mental health

status and disability of students. • 2010 – 11: 2,501,295 HE students in UK (1,912,580 undergraduate; 558,720

postgraduate) studying in 161 universities and College of Higher Education. Changes in ages and background of undergraduates • Large numbers of mature and part-time students • Those who have taken gap years • Increasing numbers of Widening Participation Students • Increasing numbers of international students



• Ref UKCISA (UK Council for international Student Affairs) 2010-11: 428,225 international students in the UK;

• An increase of 6% from 2009-10

• 17% of total student UK population

• 13% of all first degree students

• 46% of all taught postgraduates

• 41% of all research postgraduate

• 130,115 were from the EU

• 298,110 were from overseas

• 2010-11, at Kings College London – 6,100 students = 24% of student population at KCL


Top 10 Non-Eu Sending Countries to UK Top 10 non-Eu Senders 2010-11 2009-10

China (PRC) 67,325 56,990

India 39,090 38,500

Nigeria 17,585 16,680

United States of America 15,555 15,060

Malaysia 13,900 14,060

Hong Kong (Special

Administrative Region)

10,440 9,945

Saudi Arabia 10,270 8,340

Pakistan 10,185 9,815

Thailand 5,945 5,505

Canada 5,905 5,575


Top 10 EU sending countries to UK

Top 10 EU senders 2010-11 2009-10

Republic of Ireland 16,855 16,595

Germany 16,265 15,425

France 13,325 13,780

Greece 11,630 11,785

Cyprus 11,320 11,160

Poland 7,330 8,415

Italy 7,100 6,650

Spain 5,795 5,720

Romania 4,625 3,190

Bulgaria 4,615 3,395


• International students come from a wide range of cultural, ethnic and religious backgrounds and may face additional challenges adjusting and studying in the UK

• They may experience loneliness, disorientation and experience psychological problems as a result of the pressures of being away from home

• Enormous pressure to succeed which may result in them becoming very troubled if their academic performance falls short of their expectations.

• At KCL, there are orientation and cultural awareness programmes.


Government Responses

Past government funding to meet the increased need for support services has given way to a reduction in funding for higher education and the 2010 trebling of tuition fees from £3,000 to £9,000 per annum

Cuts in staff/student ratios increase pressures for staff with a resulting effects on students

Academic staff under constant pressure to maintain and improve research output as well as develop their teaching.


Social changes

• Higher rates of family breakdown, economic recession, changes to the immigration visa system, increases pressure on existing systems.

• What more can and should universities do to facilitate development and learning?

• Research at the University of Westminster (2012) reports that belonging to a peer group and to an institution are significant factors in student physical and psychological health (Ref Hixenbough et al, January 2012)

• UK National Studies have demonstrated that students are a vulnerable group in terms of mental health difficulties which is a generic term used to cover a wide range of mental distress which may affect anyone at any time

• 63% of universities report an increase in psychological distress amongst students (AUCC 1996-7)

• Schizophrenia is the most common form of mental illness with the first severe episode occuring between the ages of 18 – 30 years (IRSS Project, 1994)

• Manic depression commonly begins between the ages of 16-25 with one in every 100 individuals being diagnosed as suffering from this illness (Manic Depression Fellowship 1990)


• The largest group of males who attempt suicide are between 20 – 24

• Suicide, second to accidents, is the second largest cause of death in 15-24 year old men

• Between 1985 – 2005, suicide attempts increased by 170% (Royal College of Psychiatrists Report – ‘Transitions in Young Adults with Troubled Lives’

• 2000 - 2004 – a survey of 18 universities reported a 20% increase in students needing psychological counselling.

• 2010- 11, Kings College London Psychological Counselling Service saw 1,711 students = 7.5% of the KCL student population of 22,733

• It is estimated that 1 in 4 students will experience some form of mental distress during their time at university.

• Mental health – no longer a minority issue.


Structures and Best Practices in UK Higher Education (HE) Institutions to deal with Student Mental Health Problems

Mental Health Policies and Reports 2000 – Committee of Vice-Chancellors and Principals (CVCP) now Universities UK require

universities to produce a mental health policy.

Features of the KCL Policy include:

Duty of Care to the KCL community

Information for staff about the various types of mental health problems

What to do in an emergency/crisis

What do to if a student refuses help

When a student discloses a disability 2002 – Universities UK published a report on reducing the risk of student suicide 2003 – Royal College of Psychiatrists Report recommend University Counselling Services should be

adquately resourced 2011 – Royal College of Psychiatrists Report made 14 recommendations relating to the changing

demography of the student population


Student Counselling Services

First University Counselling Service established 60 years ago at the University of Leicester

AUCC (Association of University and College Counselling) established 40 years ago – a sub-group of BACP (British Association of Counsellors and Psychotherapists)

2002 AUCC Report all UK universities except two have psychological counselling services – all funded by the individual institution

Average ratio of students to counsellors approximately 1 FTE to 3500 FTE students

Work of University Counselling Services:

Is related to the demands of the different student groups including mature and post-graduates

Role of counsellors helps maintain student retention rates by helping students connect between mental health and their ability to learn

Work of counselling services – provide a range of interventions from brief drop in services to brief focal and longer-term therapy and psychiatric support


KCL Counselling team

Multidisciplinary – psychoanalytically trained psychotherapists, counselling psychologists, group analysts and a consultant psychiatrist/psychoanalyst

We offer both individual and group work as well as CBT, psychoeducational group, workshops on a variety of issues e.g. study/exam anxiety, procrastination and study difficulties for postgraduates, insomnia, loss and bereavement, low self-esteem and how to cope with anxiety and depression – plus a Workshop ‘Coping with University Life’ for first year students and participation in a ‘preparation for professional practice’ course for final year medical students

We have also introduced a cross-cultural awareness programme for undergraduate and postgraduate international students

• Some university services use e-technology e.g. Online multi-media programmes such as CALM or online discussion boards

• Evaluation techniques include CORE – Clinical Outcome Routine Evaluation

• 2002 – A study of 360 students found a link between ill-health, financial instability and low student retention


Training offered to staff and students 2002 – HUCS (Heads of University Counselling Services) report showed that 80% of

university counselling services offer training in mental health issues to staff and over 50% to students

Counsellors in HE understand the connection between psychological and academic difficulties and their knowledge of the educational context is essential in preventing students dropping out and providing appropriate advice for all staff

Kinds of training offered

Consultation

Risk assessment and referral where appropriate

A range of therapeutic work to students and staff

Consultation with staff concerned about students

Training including suicidal awareness for students and staff

Workshops for students and staff relating to mental health issues

Peer Support programme for students

Online information about how to help with study and mental health difficulties

Contributions to institutional policy on making decisions relating to mental health matters

Collaboration with others with a responsibility for mental health wellbeing

Personal Tutor System

All UK undergraduate and postgraduate taught students are assigned a personal tutor whose responsibilities are:

• To be a responsible person in whom the tutee can confide

• To provide support and encouragement where appropriate

• To provide a link between the tutee and the College

• To assist tutees to find the right pathways to resolve problems

• To either monitor the progress of tutees or have access to the progress records of tutees as appropriate to the School/department structure

• To refer students at the earliest available opportunity to professional colleagues.

• Senior tutors give support to tutors who may be concerned about a particular situation or student

• KCL provides a Tutors Guide which includes how to handle mental health issues

• Workshops provided particularly for new staff or students’ psychological development


Training for Students • Students may be the first to notice that a fellow student may be experiencing mental

health difficulties • Literature provides guidelines • Counselling Service offers guidance to students worried about fellow students • Some universities have a ‘buddy’ programme • Universities of Oxford, LSE, Reading and KCL have Peer Support Programmes which offer

training to students on non-judgemental listening and communicating • Student Unions are a powerful lobby in students’ interests and have information and

welfare sabbaticals • At KCL, liaison with Students Union and Counselling and Health Centres to promote

campaigns relating to mental health,drug addiction, coping with exam anxiety, anti-smoking campaigns etc

• Many universities have a ‘Nightline’ Service which is run for students by students usually between 6.00pm and 8.00am and offers confidential listening and information

• Induction programmes for all 1st year students introduce them to the services of the university and academic departments

• At KCL international students are invited to join a 3 day orientation programme to the UK, London and the university.


Student Support and the Student Experience

Student Support Services

• Most psychological counselling services within UK universities operate within a framework of Student Support Services which at KCL include:

• Disability Service; Accommodation Service (including Halls of Residence staff); Chaplains, Careers, the Health Centre, Fitness and Sport, Welfare and Financial Advice and International Student Advisors

• There is also a general information service called ‘The Compass’ all under the umbrella of the Directorate of Students and Education Support


Disability Service • Established 2005 as a result of the DDA to develop and deliver policy for any

student with physical or mental disabilities or learning difficulties – cross referrals with the Psychological Counselling Service

Student Health Centre

• At KCL, good liaison between the Counselling and Health Centres – regular referrals to the Counselling team and the Consultant Psychiatrist – example of an excellent good practice

• In university counselling services where there is no psychiatric provision – referrals will be made to NHS Psychiatric Services or to a university mental health advisor whose function is to liaise with external mental health services


The Student Experience • A significant wide-ranging term with the aim of addressing the needs of the wide

variety of students in UK HEIs

• An increasing emphasis on students being ‘consumers’

• Pressure on universities to provide excellent teaching, support and facilities within the constrained funding environment

• The effect of the increasingly competitive market place is to expect students to engage in extra-curricular activities

• As a result students have additional pressures to balance non-academic activities with academic work

• Increasingly, extra-curricular activities are an essential part of the student programme

• Establishment of the Student Charter which sets out the Institution’s mutual expectations of its students


Outcome measures and reporting back

• In 2011, AUCC research into the impact of counselling on academic outcomes – including retention, achievement, student expectation and employability (Data from 1,263 students from 42 universities)

Pre-existing evidence

• 75% of students were improved or recovered as opposed to 71% in primary care

Waiting Times

• Average waiting time in HE Counselling – 9 days – Primary Care Counselling – 63 days

• Average waiting time between referral and first counselling session in HE – 16 days – in Primary Care Counselling - 84 days


Quantitative Findings

Retention • 58.3% indicated counselling was an important factor

• 25.3% , one of may factors in helping them stay at university

• Total 83.6% considered counselling to have helped them stay at university

Achievement • 51.9% indicated that counselling was an important factor

• 29.4% one of many factors in helping them do better in their academic work

• Total = 81.3%


Student Experience

• 58.4% indicated Counselling was an important factor

• 26.8% one of many factors in improving their overall Student Experience

• Total = 82.5%

Employability

• 57.1% indicated counselling was an important factor

• 23.4% one of many factors helping them develop skills – useful for obtaining future employment

• Total – 80.5%


Qualitative Findings • Counselling Interventions which were most valued were emotional containment,

understanding, being offered new prospectives and new tools for coping • Main impact of counselling – students developed increased understanding and

increased ability to cope • Their outlook was more confident, more optimistic and more hopeful about the

future • 16.8% found counselling unhelpful

Reporting Back • These and other research findings generally form part of an Annual Psychological

Counselling Report to the University Management. • Thus providing an evidence-base for the value and effectiveness of in-house

counselling in universities • National organisations – AUCC, BACP, AMOSSHE (Association of Managers of

Student Support in Higher Education), report to Universities UK (Vice-Chancellors) which in turn reports to the Government Department of Higher Education.

• Students are the wealth, creators and providers of the future – we neglect their mental health at our peril!

• Thank you for your attention!



COUNSELLING SERVICES IN

RETHINKING EDUCATION …

Mental Health and Learning Support Strategies

… with examples of „good practice“

from Austria

45 Eva Egger-Zeidner, PSB Austria

Students in Austria

Number of students: International students:

1970: 45.000 1970: 13.000

2001: 240.000 2001: 27.800

2010/11: 313.000 2010/11: 64.500


Countries of origin of

international students in Austria

• Germany 41%

• Italy (South Tyrol) 12%

• Former Jugoslavia 12%

• Other Eastern Europe 19%

• Rest of Europe 7%

• Turkey 3%

• Non Europe 6% 47 Eva Egger-Zeidner, PSB Austria

VARIATION OF STUDENTS‘ PROBLEMS

International and Austrian students report:


International Austrian

Problems with concentration, studying 35% 27%

Stress related health problems 20% 16%

Mental health difficulties 19% 14%

Psychological Counselling Service

• In existence since 40 years

• Prevention of „drop outs“ and delay

because of students‘ problems; to help

students cope with stress


Organisation of Psychological Student Counselling in Austria

50

Ministry of Science

+/- 50 Counsellors

Trainees Consultants Assistants

6 branches

Eva Egger-Zeidner, PSB Austria

Major Areas in Psychological Student Counselling


Feed back of results to

politicians and public panels

Individual and Group Counselling,

Coaching, Psychotherapy

Cooperations with: - High Schools

- Psychosocial Services

Networking with: - Universities

Cooperations with universities

• Workshops for teachers at universities

• Regular interactive exchange and training for university staff

members

• Courses during the introductary weeks

• Courses and support for theses in psychology

• „Peer2Peer Counselling“


Example of „good practice“: cooperations of Psychological

Counselling Services with universities in Salzburg

• Coaching and counselling of university teachers and

administrative staff

• Workshops for counsellors of University Support Services

• Cooperation with academic curricula designers


54

Example of „good practice“:

cooperation with Medical University Graz

• Psychological Counselling Service as part of the „Peer2Peer

Helpline“

• Direct referrals of students with mental health problems

• Feedback of issues to university by guarenting clients

confidentuality


55

„Peer2Peer Helpline“ at the

Medical University of Graz


56

Example of „good practice“: cooperation with

High Schools: the „Studienchecker“

• Cooperation project of Ministery of Education and

Ministery of Science and Research

• Targets: profound decision process for reaching

maximum results in choice of study

• Means: teachers training, group counselling

• Primary evaluation of project shows positive results


• Information leaflets for students and staff

• Publications provided to heads of university departments and relevant

politicians:

- annual report, evaluation reports, publications

• WEBSITE:

www.studentenberatung.at

videos on „youtube“

57

INFORMATION SOURCES


"Universities are not

businesses producing education,

but a space for personality development!"

Thank you for your attention!

contact: [email protected]


the role of psychological counselling in rethinking

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