The 2006 annual report from the Crosscare Teen Counselling service was published recently.1 The report brings together information from the five teen counselling centres operated by Crosscare in Dublin.  The overall aim of the counselling service is to enable young people and their parents or carers deal with family conflict, mental health, substance use and behavioural issues among teenagers within the context of the family. The service saw 400 families in 2006, which included 248 new cases and 152 cases carried forward from 2005. Of the new cases, 44% of teenagers were living with both biological parents and 85% were in secondary school. Sixty-seven per cent of new teenage clients were aged under 16 and 55% of these were female. Fifty per cent of new teenage clients reported drinking alcohol and 23% reported using a drug other than alcohol, with cannabis (17%) the most popular. 

The report includes results from an internal evaluation of the service in 2006 based on four strands: 

1.  Parents were asked to assess the severity of problems they were experiencing and their ability to deal with them at baseline and again when therapy was completed. Sixty-five per cent of parents who completed this process reported a great reduction in the severity of problems and 34% reported some reduction.  Fifty-four per cent said their ability to cope had greatly improved and 45% said there was some improvement. 

2. Teenagers were asked to assess the severity of their difficulties at baseline and again when therapy was completed across four domains: at home, in school, among friends and self.  Improvement was reported in all domains, with 96% reporting improvement in relation to problems they attributed to self. (Table 1). 

3. Counsellors evaluated all cases that had completed therapy in 2006 (n=256) on the severity of problems that they presented with and their underlying problems. Thirty-nine per cent reported improvement in the problems families presented with and 44% reported improvement in the underlying problems. 

4. Counsellors used the Global Assessment of Relationships Functioning DSM-IV to measure family functioning at baseline and again at therapy completion. When therapy had completed the average for family functioning was scored at 87, an increase from 56 at baseline. Higher scores are indicators of improved functioning among families. 

Counsellors used the Global Assessment of Functioning DSM-IV to assess how well teenagers were functioning at baseline and again when therapy was completed. On completion, the average score was 69, an increase from 58 at baseline, indicating that some improvement had occurred.   

However, the results of this evaluation must be treated with a degree of caution as it cannot be definitively shown that the improvements reported by participants and staff were due to the intervention because the evaluation did not control for competing explanations. For example, the severity of problems could have reduced with the passage of time and the capacity of parents/teenagers to cope with problems could have improved with time, without either being affected by the intervention. Given that families received counselling for an average of nine months, the issue of time is important. One way that the evaluation could have controlled for this competing explanation would have been to compare parents and teenagers receiving the intervention (experimentals) with a group of similar parents/teenagers on the waiting list for the intervention (controls). The report notes that 41% of referrals to the programme in 2006 were placed on a waiting list. 

Despite the limitations of the evaluation design, it would appear that the Teen Counselling service provides a much-needed response to families in distress and is well regarded by professionals. The majority of referrals to the service were by schools, family doctors, psychologists, counsellors, social workers and health professionals. Engaging and maintaining participants in counselling presents challenges to service providers targeting ‘at risk’ families. The report notes that including parents in the work and providing a locally based service that is not stigmatised are key elements in the success of the service. 

1. Teen Counselling (2007)Teen Counselling annual report 2006. Dublin: Crosscare.