Service levels and professional standards

• Foreword
• Introduction
• We are part of a Team
• Our philosophy
• Our Catchment Population
• Staff Qualifications and Training
• Data Protection and Confidentiality
• Ethics
• Evidence Based Practice
• Objectives
• Urgent and Emergency Appointments
• Routine Appointments
• Priorities
• Compliments and Complaints
• How YOU can help us to improve Service Levels

Foreword

This page outlines the service levels and professional standards relevant to our work when counselling individuals. We do a large number of things apart from that, including the provision of study advice for individuals. A brief introduction to the service therefore follows to provide some context.

Introduction

The University of Reading Counselling and Wellbeing Service was founded in 1975 with just one counsellor. Today, 2012, the team consists of 4 full-time equivalent counsellors, 0.5 full-time equivalent Peer Support coordinator, and 1 full-time equivalent Mental Health Adviser. These professional staff are counsellors, mental health adviser (with Social Work background) and chartered psychologists. The team is supported by our 1.3 full-time equivalent administrators.

In August 2011 the Student Services and Academic Services Directorates merged. Now the new section is called Student Wellbeing and it includes the Counselling and Wellbeing team and the Disability Advisory Service team.

As part of our work to support students we provide a range of self-help and information leaflets of which this is one, and a wider range on our website. In addition to seeing students for one-to-one counselling sessions, the Service provides a range of psychoeducational talks for self-management and to develop resilence. In addition, the Service provides input to training for Tutors, Hall Staff and others through the Centre for Staff Training and Development. The subjects range from helping skills to stress management and cultural adjustment. The Service also provides much student development support by providing training for students who wish to contribute to the university community through the Peer Support network.  We also provide considerable input to University policy making, for example,  contributing to University procedures on students taking time away from studies on personal/health grounds.

The Service falls within the Division of the Director of Student and Academic Services. The Head of Service reports to the Director of Student Services as line manager; with responsibility to the Pro-Vice-Chancellor (Research) through Health and Safety Committee, for Staff Counselling; to the Pro-Vice-Chancellor (Resources) through the Student Welfare Committee, for Student Counselling; and to the Pro-Vice-Chancellor (Teaching and Learning) for other academic support. We are active on numerous committees, for example, the Disability Advisory Group and Supporting Students Experience and wellbeing. On staff issues we work closely with Human Resources as well as advise Heads of School on student and staff matters. We provide professional advice to a number of Senate Committees, for example, on examination failures and examination appeals.

Service Levels actually achieved across all areas of operation are spelled out each year in the Annual Report of the Service. These Reports are documents which go to Senate, Council and other University Bodies for approval, comment, information, discussion and feedback. This is not just bureaucracy. Members of Council, for example, have visited the Service and have asked for further information, questioned policies and debated issues of substance raised in the Annual Reports. This is genuine external scrutiny and accountability in action alongside internal scrutiny by both elected students and University management. So this is a Service with a remit running from student pre-admission assessment to cultural adjustment on graduation, from the psychiatric to remedial academic support, from staff support and training through stress and Health and Safety issues. 

We are part of a Team

The University Counselling Service is very much a Team of nine professional staff and two secretary/receptionists. Without good teamwork we could not provide a high quality Service. We are also part of the wider team which is the Student and Academic Services and attempt to provide our clients with a seamless web of service. We attempt to manage our relationships with non-divisional staff in such a way that the seamless web also applies. For example, the Tutors, the medical staff and the Wardens work closely with us. We also liaise with the Students Union's representatives and elected Hall Welfare Representatives as well as "ordinary" students. Through cooperation and collaboration we aim to provide effective support to students and staff.

Our Philosophy

Underpinning all aspects of Service operation is our philosophy, one we hope shines through when it matters. We try to treat others with the respect we would like accorded to ourselves, we try to be as transparent as possible in our dealings with others. We try to be both fair and flexible to all in allocating resources. This is not just theory; we will give priority to those who are at risk and support the university community when there are critical events. We try to provide clear information in very complex circumstances. We try to provide the most professional service we can, informed by current guidance from professional bodies, Universities UK etc. We regard client feedback and regular surveys of it as crucial to managing and evolving the Service.

Our Catchment Population

You are entitled to use the University Counselling Service free at the point of delivery if:

• You are a currently registered student with The University of Reading
• You are a current member of The University of Reading staff
• You are a current member of staff of The University of Reading Students Union

You are not entitled to use the Service if:

• You are a retired member of staff
• You are a family member of a current member of staff
• You are a family member of a current student
• You were a registered student but have withdrawn
• You were a registered student but have suspended your studies
• You are a student at any other University or any other HE (or FE) Institution
• You were a student but have graduated

You may be permitted (exceptionally) to use the Service if:

• There is a contract in place between us and any NHS facility which provides for you. A letter of referral is required
• There is a contract in place between us and any private institution on or off campus. A letter of referral is required
• Arrangements have been agreed with the Head of Service for you specifically as a special case. This may be at the request of the Pro-Vice-Chancellor (Teaching and Learning), a Faculty Director of Teaching and Learning, a Senior Tutor or Tutor for example

Those who were registered students, but who have suspended, often suspend for psychological or emotional reasons which have been too severe to sort out while continuing their studies. Students, when ready to return, can contact our Service to arrange a fitness to return assessment. 

Staff Qualifications and Training

All of our staff are professionally qualified, experienced and accredited. Although we put them under the generic term "Counsellor" for convenience and in accord with University tradition, the professional qualifications range from counsellors, psychotherapists, Chartered psychologists and a Mental Health Adviser training. They vary in professional allegiance (BACP, UKCP or the British Psychological Society) and training to give varied expertise for varied client problems. The University Calendar (annual editions) contains up to date staff details as does our website.

The work of these professional staff is subject to professional disciplines as well as University discipline. These standards are set by the professional bodies (not the University or Service). Staff have regular clinical supervision to support their work to provide effective support to students. Supervisors work independently and externally from the Service. In addition, we provide peer supervision for each other. Each professional must undertake continuing professional development to ensure awareness of best practice in the field.

Data Protection and Confidentiality

For your convenience a summary and overview of our standards is provided when you register with us and on intake sign your permission for us to keep a record about your visits. This is a complex area however. We therefore also provide a very detailed leaflet "Confidentiality and Data Protection" - how we keep the personal information you provide - so that you will be in no doubt about our policies and procedures.

Ethics

On our notice board you will find copies of "Ethical Framework for Good Practice in Counselling and Psychotherapy (British Association for Counselling and Psychotherapy) and "Guidelines on Confidentiality and Record Keeping" (The British Psychological Society). These are the standards which inform our practice. Our leaflets "Data Protection and Confidentiality", "Student Counselling" and "Staff Counselling" discuss how we apply these documents to our specific practice.

Evidence Based Practice

Not every intervention used professionally in medicine, psychology and counselling has been adequately researched but in so far as it is possible we provide a client with what in our professional view is the intervention for which there is most adequate evidence and which in the light of their unique circumstances is most likely to benefit them.

We draw your attention to Choosing Talking Therapies? (2001) published by the Department of Health and also to Treatment choice in psychological therapies and counselling: Evidence based clinical practice guideline (2001) also published by the Department of Health.

In addition to using evidence based interventions, we also where possible check our effectiveness by using a standardised before and after measure called CORE (Clinical Outcomes in Routine Evaluation). This enables us initially to get a very quick evaluation of risk crucial to our standards of service. CORE also enables us to compare the scores for our intake population against other populations and the score shift, if any, from "clinical" to "normal" population as counselling makes its impact. We have been implementing this system over the past four years and hope to greatly improve it by using tailor-made software, CORE PC, when resources allow.

Using CORE data, over 70% of our clients in a recent large sample were within the NHS clinical CORE data range on intake. Over 70% of these clients showed reliable improvement after counselling and 60% of the clients saw their score move from the clinical to normal population range. Further clients showed improvement, but not at a statistically reliable level.

Regardless of the nature of evidence for an intervention it is no good if it is not acceptable to the client. Nor does a score shift necessarily mean a client is happy or satisfied with our work. We therefore have a third level of check - we survey client opinion on how we are doing and do so in different ways from year to year in best "triangulation" fashion. These surveys form part of our Annual Report data each year.

Objectives

The University Counselling and Wellbeing Service is a short-term counselling service, not a long-term psychotherapy service. We aim to ensure that whatever the personal problems experienced, the impact of reduced concentration and motivation, etc is kept to a minimum and capacity for academic achievement restored as soon as possible. Following initial assessment of the problem we will discuss options and suggest the intervention we feel most appropriate, enlisting the help of other University services and/or referring out as necessary, and where possible. While acknowledging deeper needs which must be addressed in the longer term, we are sometimes reluctant to encourage students who have achieved some stability in managing chronic problems, usually with considerable help from us and others, to dig too deeply into background issues. Digging deeply may risk renewed emotional instability at times of sustained academic demand. As well as traditional counselling we therefore offer well informed support and containment for problem management, with less frequent appointments over a longer period.

The clinical outcome evidence is that for the majority of problems presented to counsellors and psychotherapists in general practice, as well as in University settings, benefit can be derived in brief interventions. Each Year the annual average number of sessions is about 4.5. The clinical outcome evidence for a significant group of intractable and chronic problems - such as eating disorders - is that many sessions may be needed to make significant progress. Our resources permit us to support students so they can engage with NHS services. Finally, the clinical outcome evidence for some problems, such as personality disorders, is that long-term work both individual and group may be needed. We are not resourced for this.

Students who prior to admission to the university have benefitted from considerable psychiatric, psychological or counselling support may benefit from University Counselling Services facilities once at university. If however, prior to admission, the expectation is that intensive long-term support or very consistent professional support will continue to be needed throughout all or most of the university years, it is essential to check prior to accepting a place that appropriate resources can be provided. It may be possible for the university to provide specific funding for the purpose of long term care, or for funding to come from a disability allowance or other source, but it should not be assumed. The local NHS and university facilities try to work closely together, and Mr Charles Kenderdine, (University Mental Health Adviser, based at the University Health Centre), is well placed to discuss need and resources, as is the University Disability Office.

No Emergency Appointments

We are not an emergency service. Students or staff who need immediate support should contact their GP or call NHS crisis numbers. Depending on how busy our Service is we will aim to respond to consultations on how to support students or staff who are in distress. If we have availability we may be able to offer a brief conversation to discuss options on how to manage the difficulties being experienced at the time.

To arrange an appointment to see a counsellor or the Mental Health Adviser students and staff can contact our administrators on 0118 3784216 or email counselling@reading.ac.uk.

(There is a fee of £50 for staff counselling, however, if the difficulties are work related there might be exceptions. Staff can consult with our Service if an exception can be made in their case, or contact HR for further information).

Priorities

Much of the ethical framework documentation to which we have drawn your attention is concerned with our duty of care to individual clients. We also have a duty of care on behalf of The University to the community. Our leaflet "Confidentiality and Data Protection" spells out in detail, illustrated with case studies, some of the community implications.

However, our top priority is risk management. We will give priority to those who are suicidal, self-harming, in danger of harming others or in danger of being harmed by others.

Students who are concerned, sometimes deeply concerned about the behaviour or welfare of others and who live in a Hall of Residence normally have a Warden to whom they can turn for advice. Students who live with other students, as in private housing, do not readily have anyone to turn to for advice. The latter are a top concern for us. This is partly because such students may flag up risk, and partly because such students need sufficient support not to become so enmeshed in the problems of others that they destroy their own academic progress.

Regardless of the clinical risks above, we also have a special concern for academic risk as rapid intervention can prevent a student falling behind so far that even extending deadlines fails to maintain academic viability.

 

How YOU can help us to improve Service Levels

Despite every effort on our part we find that student clients do not arrive without explanation for about 5% of booked appointments. We recognise of course that anxiety and depression impact on concentration, memory and capacity to organise oneself but we can provide you and others with a much better level of service if:

you provide us with accurate information on how to maintain contact with you.
you always let us know as soon as possible if you wish to cancel or change an appointment so we can allocate the time to others.

 

Compliments and complaints

The feedback you give us is welcome regardless of whether it is a compliment, a complaint or simply a helpful comment or observation. As we are subject to normal human frailties, things occasionally go wrong.

In general terms we would like you to give informal verbal feedback to your counsellor if you regard the matter as minor. If you are not happy with the outcome of that, or if the matter is, in your view, serious or significant, we would like you to write formally to the Head of Service. You will get an immediate acknowledgement in writing, and when the matter has been investigated, you will get feedback in writing. If you are not happy with this, please write to the Registrar. If you have a complaint about the Head of Service, you should write to the Director of Student Services. As a matter of good practice, any complaints in writing will be copied to the Director even if we deal with them ourselves, as will our response. You can download a copy of the Student Complaints Procedure (reflected above) from Guide to policy and procedures for teaching and learning (Quality Assurance Process).