Counselling is all about talking, isn’t it? Well, no. One little girl at Oakwood Primary School in Glasgow went along to her first 40-minute counselling session at the school and didn’t speak a word. Instead, she headed straight into a little faux circus tent in the corner of the room and stayed there for the duration. The same thing happened the next time and the next. It was only in the sixth week of counselling that the girl actually spoke.

Another child, also at the school in the Easterhouse area of the city, gravitated towards a toy house. He used dolls to act out a scenario where a house was on fire and its occupants needed rescuing.

This, it turned out, was the escape valve for deep-seated memories of a traumatic episode he had been though - which school staff had known nothing about - when he had escaped from a real fire.

Both children opened up, in their own way, in counselling sessions run by the Place2Be service, which has been based in the school since 2013. Children communicate in a host of different ways, whether through play, art or even silence. In the Place2Be room at the school - which is sacrosanct and never used for anything else, even on days when the service does not operate - there are cuddly toys, board games, a sand pit, art materials, maps and myriad other stimuli. The children in the room decide what, if anything, they will use to express how they feel.

There has been much talk recently about a need for “school-based counselling” in Scotland’s schools (see box, opposite) amid concerns that there is a mental health crisis among children, but the fact remains that, as we enter 2019, there are very few schools where it is happening.

And there are widespread misconceptions about counselling. Oakwood headteacher Vanessa Thomson, for example, wonders if people appreciate the level of commitment needed: counselling involves far more than a sudden, cathartic release for a stressed child.

“This is not a quick fix - it’s a long-term investment in a child’s life,” she says. Even the most perceptive teachers may “not have an inkling” that something is wrong with a child who could, for example, be living in the midst of “really serious domestic violence”, but counselling may pick up a problem in P1 before it manifests as troubling behaviour in the classroom several years later.

Anne Crawford, a counsellor and Place2Be project manager at Oakwood Primary, spends two-and-a-half days at the school, and says that being a well-known face makes her work easier. “It feels so much different because you’re part of the school: you have relationships with staff, you can walk down the corridor and the children will know you - it’s a normal thing. And parents come in and ask about things whereas, if I just appeared, they wouldn’t do that.”

Counselling - also available to Oakwood teachers - is not a furtive, secretive activity in the school, where you’re liable to hear pupils proclaiming, “Can I have my lunch early? I’ve got a Place2Be!”

Theraputic relationships

Almost every child in the 200-pupil school, on Glasgow’s easternmost reaches, has used the counselling service at some point, whether through planned and structured one-to-one sessions with Crawford or “Place2Talk” drop-ins, where small groups of children might speak to her about their worries.

The Place2Be approach is founded on “attachment theory”, which, according to the organisation’s head in Scotland, Jonathan Wood, has “many facets” but boils down to the key principle that “children need positive and loving relationships to thrive”.

Where this has not been evident in family life, he says, a “therapeutic relationship, by being consistent and child-led, offers an alternative experience for the child, where safe relationships are possible”.

He adds: “The hope is that the child then feels safe enough to build on that model, make friends and develop, rather than defend and reject any approaches.”

Thomson says the counselling service has been critical to the creation of a “tangible feeling of calmness and kindness” around the whole school. There are now far fewer flashpoints involving pupils: previously she “couldn’t physically write them all down because there were so many in the day”, but now, weeks go by without one.

Place2Be does not focus entirely on the child, however: some Oakwood parents are also offered counselling.

Isabel Gibb is one. She talks about the devastating impact on her family when her children’s father killed himself in October 2017: counselling helped her “not pass on the hatred I had for their dad” in the aftermath.

Crawford and other Oakwood staff helped her to break the news to her children, make some sense of what had happened and be truthful about the circumstances of his death. Gibb talks about the “immense help” of being able to access support in a place where she trusts the staff and does not have to jump through hoops to get to an external service.

“I don’t know where I’d have been [without it] - I wouldn’t have gone to the doctor.”

Now, she finds herself able to think “happy thoughts” about the children’s father - previously unthinkable - while “the kids are more open, they don’t hold on to their problems anymore”.

“Every school should have somewhere where the weans can go to talk about how they’re feeling,” she says.

Another parent, Heather Hood, is a force of nature in and around the Oakwood School community - where five of her children are or have been pupils - as a member of the parent council there and at the local secondary school, as well as in roles in her church and the Boys’ Brigade.

She talks fast and frankly, and Place2Be is a subject that particularly fires her up.

“This should be in every school - the fact that it isn’t is an absolute disgrace. It should be available to every child and every school, regardless of where you are demographically.”

The memory of the cot death of her 11-month-old daughter, nearly 20 years ago, “still breaks me every day”, she says. In the next breath, almost in passing, she mentions another traumatic incident that occurred nearly a decade ago. About two-and-a-half years ago, she hit “rock bottom” when she lost her house and her mum died; “I’m just waiting to hear from Dolly Parton - there’s a song in there somewhere”, she says.

Hood received support from Place2Be. And that support, she says, “actually did save my life”.

Hood speaks passionately about the importance of early-intervention counselling, long before adulthood, and her fears that, without such support, many children will seek pharmaceutical pain relief in years to come and be “stoatin’ aboot” on antidepressants like “wee robots”.

“If you can get in the now [with school-based counselling] you must - this should be part of education, it shouldn’t be a luxury.”

School-based counselling is more usually associated with secondary schools, but St Thomas of Aquin’s High in Edinburgh, where a Place2Be service is in its third year, remains a rare example in Scotland.

As at Oakwood, the service runs two-and-a-half days a week, with one room for more structured one-to-one sessions for pupils who have been referred - whether by themselves or someone else - and another for an ad hoc service, where pupils might attend in small groups (see box, above right).

“At some point in their life, everyone will need help,” says Alexia Gaitanou, Place2Be project manager at the school. She stresses, however, that one big event may not be the trigger. “You might have little worries and they look like little stones, but suddenly they make this massive big mountain…and you don’t know which stone to take out first, or else [it feels like] it will just collapse in front of you.”

Gaitanou’s room has the toys, coloured pencils and inspirational epithets you might expect in such a place but, also, less expected items, such as a large black-and-white drawing of a screaming mouth within a mouth within a mouth.

It’s crucial that not everything is “all fluffy”, she says. “I make this room look cosy and nice, but people come here to say and bring their ugly stuff, so it has to empower them to say that.”

Working with families

It is in secondary schools that the impact of long-term counselling comes into sharp focus.

Becky Wilkinson-Quinn, Place2Be service manager at St Thomas of Aquin’s, talks of one girl, now in secondary school, who in P1 would never leave the classroom or her teacher’s side. “Even going to assembly was too much,” she says.

Counselling started in P2, but she was “frozen” like a “rabbit in headlights” and rarely stayed for a whole session.

It turned out that she was living in a “family at war”, where drug use and violence were prevalent and her dad was an intermittent presence - he sometimes lived with the family of other children in the girl’s class.

Eventually, despite saying very little, she expressed herself through artwork, creating idealised family portraits with lots of glitter, which showed her desire for a better relationship with her mother.

However, the mother was very negative about her daughter, and the two clashed constantly at home. Mary Gray, a Place2Be parent counsellor, recalls that the mother “had just never experienced anyone being kind to her”, having had a “horrible life” with “nothing but violence from everybody - everybody had cheated on her and lied to her”.

But counselling, says Gray, revealed that within this “very loud and aggressive” exterior was an “incredibly kind” person.

This scenario, says Gray, shows a constant problem for school-based counselling: “We can’t control what goes on outside.”

It is, nevertheless, one example of long-term support leading to some clear successes.

“We went from a mum who was unable to say a positive thing about her child and was scathing about her, to picking her prom dress and [her daughter] having a lovely prom.”

Wilkinson-Quinn says that, to begin with, it is not uncommon for some teachers in a school to feel that school-based counsellors are “stepping on their toes”, but they tend to come around when they see the impact.

Whole-school effort

St Thomas of Aquin’s deputy headteacher, Isabelle Jean-Pierre, says it is important that counselling services are matched by whole-school efforts to improve staff understanding of related issues: Gaitanou, for example, as well as providing counselling, also leads the school’s mental health awareness week.

It costs £33,000 for two-and-a-half days a week of Place2Be - including Gaitanou and four volunteer counsellors - but Jean-Pierre believes the return is more than worth it.

The school was already known for its work with pupils who have complex additional needs, but Place2Be has made it “much more sensitive” to students’ individual needs and staff more aware that the “tiniest of changes” in a pupil’s life can have an impact.

Culturally, there is little sign of stigma or shame around mental health at this school: the two pupils I talk to (see box, above) carry on discussing their personal circumstances and mental health troubles with me in one of the busiest corridors, even as the lunchtime bell goes to signal a passing surge of students.

Back at Oakwood, Thomson is mulling over what schools can do to support pupils’ mental health if they cannot call on a service such as Place2Be. “All schools need to be really, really proactive about how they’re supporting children emotionally,” the headteacher says. She is sure that many are, but fears that this may not be enough for every child.

“We do that well [at Oakwood], but we cannot do it as well without having the professional support, the intervention and the expertise that we do,” she says.

“I have empathy and compassion, but I’m not a trained counsellor.”

Henry Hepburn is news editor for Tes Scotland. He tweets @Henry_Hepburn

Huge disparity in provision

There is a “huge disparity” in school-based arrangements to support students’ mental health, a Tes Scotland survey revealed in August last year, prompting calls for urgent change. And in September, first minister Nicola Sturgeon announced £60 million to help improve pupils’ mental health and ensure that every secondary school has counselling services.

The survey, which had responses from 29 of 32 local authorities, found that while some were committed to specialist counselling, others provided few - if any - dedicated services and were sceptical about their value.

North Ayrshire had nine full-time counsellors employed to work across all nine secondaries, for example, while Glasgow had specialist counsellors working in every secondary and 13 primaries.

East Lothian, however, saw “limited evidence that trained counsellors will make an impact”. Midlothian, like a number of authorities with little or no specialist counselling, pointed to its educational psychologists: the council said that they can work on “universal” approaches as well as “targeted intervention for specific individuals”, whereas “counsellors can deliver for the individual only”.

Joanne Waddell, the counsellor behind a recent petition to the Scottish Parliament calling for access to trained counsellors in all schools by 2022, said services were “patchy and sporadic, with huge disparity from one region to another”.

The money announced by the first minister in September aims to provide around 350 school counsellors. There will also be more than 80 additional counsellors in further and higher education over the next four years, through an investment of around £20 million.

Sturgeon said that the £60 million for schools would also go towards an extra 250 school nurses by 2022. And every local authority will be offered training for teachers in mental health first aid by the end of 2019-20, with a “train the trainer” model helping to reach every school.

What primary pupils say

Zachary* is a P7 pupil at Oakwood Primary School in Glasgow, one of the few primaries in Scotland to have a school-based counselling service.

He’s keen to stress that Place2Be counsellor Anne Crawford is not in school three days a week purely for “really big things”, such as someone dying, but might also help children who are worried about falling out with friends. “Anne doesn’t care what it is - she’s just here to make people feel better.”

He adds: “I feel like when I’m not wanting to speak to somebody else, I can come to Anne and speak to her. It’s really easy to speak to Anne.”

And this helps when Zachary returns to the classroom: “I go back in and feel really focused and I’m not thinking about the thing that’s happening. My mind’s cleared, so I’m just thinking about my work.”

Zachary, who is 11, furrows his brow in concern when he considers that many people his age do not have that support.

“Here you can think, ‘Oh, I’m worried about this but I know that it’ll go away when I go to see Anne. Other people that don’t have counselling or Place2Be, they think about that same thing all day, and they have nobody to tell.”

Fellow P7 student Cara*, also 11, used to “always feel down about myself [and] couldn’t be myself in front of people”, acting “crazy and different” in an attempt to be liked by friends.

She says that counselling helped her see that she did not have to put on a front, with the result that one friend told her: “I like you even more now.”

*Names have been changed

What secondary pupils say

Adam*, 17, sought the support of his school’s counselling service as he dealt with a significant family bereavement.

The teenager, who is an S6 student at St Thomas of Aquin’s High in Edinburgh, says that, even when he is not actively using Place2Be, he finds it reassuring to know it’s there if needed. 

“I was worried about what people would think,” says Adam, recalling that he first accessed Place2Be in S4, when school is already difficult enough with exams looming. The stigma was largely in his own head, however, with friends proving “a lot more supportive than you’d think”.

Adam believes it is crucial not to put barriers in the way by overly formalising the process for seeking support. “Teenagers are not always the most open - so make it easy and accessible by always having an open door.”

Rachel*, also an S6 pupil at the same school, says: “It’s helped to have one place where I can deal with my mental health issues and another - the school - where I can just be myself,” she says. 

Teachers and other adults, she believes, are now less likely to “patronise” teenagers who are feeling down - she and Adam roll their eyes at the “You think you’ve got it hard?
Wait till you’re paying taxes” response that teenagers frequently encounter.

“That makes it harder to come forward, if you don’t feel like you’re valid,” says Rachel, adding that at her school, “there’s no such thing as, ‘Oh, that’s not really a big problem so you should just deal with that yourself’”.

Rachel would also like pupils to receive training and advice on how to help their friends, as peers are often the first people that pupils turn to for support.

Adam and Rachel are further encouraged by the fact that their school has an active pupil council with genuine clout: it has secured the installation of water fountains and led a campaign for a new zebra crossing near the school. If a culture of listening to the “pupil voice” is encouraged more generally, they believe, teenagers are more likely to share their mental health difficulties.

*Names have been changed