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Case study: Karen Cromarty, school counsellor, Durham

My interest in counselling began when I was a school governor sitting on exclusion panels. I saw the real needs of some of the students we had to exclude, and that there was nothing much in school to address those needs.

I started training in 1996 and in 1999 started working in Ferryhill. Two years later the educational psychology service began consulting schools about developing a counselling service across the county; the Ferryhill model was part of that consultation. A joint initiative followed between educational psychology and health as part of the county's child and adolescent mental health strategy. There are now 10 counsellors - all either accredited or applying for accreditation from the British Association for Counselling and Psychotherapy (BACP) - in 10 secondary schools from our service across the county, with more schools interested in working with us.

There is a distinction between teachers who use counselling skills in their teaching, and counselling as a professional activity. Generally BACP advises that schools consider carefully whether to use a teacher as a counsellor, because teachers have to be in a position of authority and often that dual role can threaten the trust required in a counselling relationship.

Ferryhill serves an ex-mining community with high unemployment, high levels of deprivation, teenage pregnancy, drugs and alcohol abuse. Some parents were suspicious when we started in 1999 but they are now fully supportive because they can see the benefits.

Sometimes children refer their friends and sometimes they self-refer, especially if they are feeling under-confident or having difficulties making friends. In such cases we teach assertiveness skills. We also run two Year 7 "Aim High" groups, one for boys, one for girls, to boost self-esteem and improve social skills so pupils become better at speaking in class and making friends. This has benefits across the curriculum. We also run anger management groups and a peer mentoring programme.

We are proactive in what we do because, ideally, we want children to self-refer before things get really difficult. If a child self-refers at Ferryhill they can have an appointment within a week and can usually within several sessions address their problems and move on. One boy self-referred because he kept getting angry at school and home and didn't know why. We found he had been struggling with multiple bereavements in the family, the latest being the death of a grandparent, which was causing uncontrollable anger.

Educational psychologists have huge assessment caseloads and little time to undertake therapeutic work in this way. Counsellors can fill this gap and, if need be, refer quickly to relevant services - GPs, social services, child and adolescent mental health services. At Ferryhill we also have the advantage of being part of a team which includes school nurses, a youth worker and sexual health outreach worker.

We also offer a counselling service to staff, and co-ordinate a staff health and well-being week once a term when there are no meetings after school and staff are instead encouraged to go home and take time out for themselves.

In our experience one of the benefits of being a school-based service is that it is easier to gain the trust of parents and students. You also see students in school every day year on year, and can observe the results of your therapeutic work. You see them happy with friends, enjoying life and doing well in their studies.

Karen Cromarty is co-ordinator of the Durham schools' counselling service and chair of the counselling children young people division at the British Association for Counselling and Psychotherapy. She also works 20 hours a week as a counsellor at Ferryhill business and enterprise college in County Durham. She was talking to Elaine Williams

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