Counselling With Primary School Children

1. INTRODUCTION

Drawing on a range of psychological models of practice, group work for primary school age children has been increasingly taken out of specialised clinics and into school-settings (Auger, 2004; Crespi, Gustafson, & Borges, 2005; Kulic, Horne, & Dagley, 2000; Littrell, & Peterson,2002; McArdle, Moseley, & Quibell, 2002; Riva, & Haub, 2004; Shechtman, 2002; Slavin,2002). Evidence-based practice has generally targeted specific diagnostic groups of children, such as, the treatment of anxiety (e.g. Spence, Donovan, & Brechman-Toussaint, 2000), de- pression (e.g. Weisz, Thurber, Sweeney, Proffitt,& Le Gagnoux, 1997), and grief (Johnson,2006), or in developing particular skills of empa- thy (Akos, 2000), of emotional resilience (Bar- rett, & Turner, 2001; Barrett, & Shortt, 2003), social skills (Aurelio, 2004; Campbell, 2003; DeRosier, 2004), and developing emotional in- telligence (Pummell, 2003). While personal con- struct group work has been found to be an effec- tive counselling intervention for clients of differ- ent ages and clinical problems (e.g. Jackson,1992a, 1992b; Metcalfe, Winter, & Viney, in press; Truneckova, & Viney, 2001, 2005, 2006,2007; Viney, 1998; Viney, & Henry, 2002; Vi-ney, Henry, & Campbell, 2001; Viney, Metcalfe,& Winter, 2005; Viney, Truneckova, Weekes, & Oades, 1997; Viney, Truneckova, Weekes, & Oades, 1999), few investigations have been directed at the effectiveness of personal construct group work with children. We will describe a counselling model of group work with primary school students, striving to meet the criteria provided by the APA Task Force (APA, 2005; 2006) on evidence- based practice, of treatment efficacy and clinical utility. The principles of learning centred counselling (LCP; APA, 1997) are central to the model, where diversity isintegral to the group counselling processes, the learningexperience is meaningful and relevant to the groupmembers, the group experience emphasizes dialogue,negotiation, and mutual feedback, the group leader‟s role isone of facilitator, and evaluation of the group experience islargely self-reflective (Stroh,& Sink, 2002). Theeffectiveness of this model of small-group counselling withprimary school children was tested by measuring changesin so- cial skills and self-esteem, and investigations werealso undertaken into the group processes.

AIMS

The aims of these group counselling interventions are toinvestigate the treatment efficacy and clinical utility ofpersonal construct group counselling for students withinterpersonal difficulties. 1. to explore the changes in social skills and self-esteem of students participating in group counselling. 2. to inquire into the processes of personal con- structgroup counselling. HYPOTHESIS Individual Changes Changes in social skills After group counselling, there will be an in- crease ineffective social skills as reported by the students, and theirteachers. Changes in self-esteem

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After group work, there will be an increase in self-esteem as reported by the students. Group processes After each group counselling session and at Time 2, the group members will indicate that they felt in the groups that: a) others listened to them b) they belonged c) they were understood d) they became stronger in themselves e) they became more self-confident.

Participants Fifteen students attending three government primary schools in BHOPAL, INDIA, have participated in small group work. The stu- dents, three girls and twelve boys aged between 8 years to 11 years (M=9.93 years, S.D.=1.73), were representative of the range of students in their school population, and of other students attending primary schools in the region (De- partment of School Education, 2010). The de- mographic data for the participating students reported 40% from intact families, 53% from sole parent or blended families, 7% were in care, and no children identified themselves as Abori- ginal or speaking a language other than HINDI. The students were referred by their teachers in consultation with their parents/carers. The students were described by their teachers and parents as demonstrating poor social skills re- sulting in either frequent conflict with peers, or socal isolation from peers. Informed consent was gained from the participants, and their par- ents/carers, the group work being offered as a positive way to make some helpful changes in the student‟s behaviour at school. The first au- thor was the group leader for all groups. Monthly clinical supervision took place. Group work Counselling service in the three participating schools was on a weekly basis for one school, and a fortnightly basis for the two other schools. Accordingly, the group work was conducted on a weekly or fortnightly basis, for 30 minutes or 45 minutes respectively. Each of the five groups of 3 students were closed, and the number of ses- sions ranged from 9 to 33 sessions (refer Table 1). The psychological intervention was based in personal construct theory, also drawing on an analytic approach (Cousens, 1999), where thera- peutic space and containment are maintained by a structured group environment. Withgeneral goals of improving social and communicationskills, the overall theme was of listening and try- ing tounderstand what the other member was saying. The grouprules were: maintain confi- dentiality, each person hastheir own point of view, we need to listen to each other, wetry to get along with each other, and we avoid inter- ruptingothers (Truneckova & Viney, 2007).

Table 1. Description of the group work interventions

Group Age (years) Gender Frequency of group Number of sessions Duration of group (months) 1. 8-9 boys fortnightly 9 5 2. 9-10 boys fortnightly 10 5 3. 9-11 girls weekly 33 12 4. 11 boys weekly 26 10 5. 10-11 boys fortnightly 11 6 As goal setting is integral to process and effec- tiveness(Stroh & Sink, 2002), eight working goals were developed(Kelly, 1991a; 1991b), and used to evaluate the groupprocesses through the Group Session Evaluation. Thethemes incorpo- rated in the goals were: to provideconfirmation; to facilitate a sense of belonging and a sense offeeling understood; to develop trust; to share meanings; toformulate hypotheses and design experiments leading tochange in meanings; to explore similarities and differences inand out- side the group; to apply group experiences toeveryday situations; and to grow in self-esteem. The group work began with the participants filling in the topsection of their session evalua- tion sheet, then telling news,and asking ques- tions of the news-giver, followed by themem- bers taking part in the group activity, and report- ing onthe group activity to the group, and finally the memberscompleting the session evaluation sheet. Depending on thegroup members‟ abili- ties to articulate their feelings andthoughts, the group activity focused on either a verbal or non-verbal task(s). The structure of the group activity for eachsession, involved each participant being the group leader, andas the group leader for that session they would choose thetheme for the ac- tivity such as friendly/unfriendly, playingto- gether/fighting, and they would also choose the mediumto be used, for example „play doh‟, drawing, painting,craft, turn-taking games. As group leader, they would thenreport on the group‟s achievement(s), and lead thediscussion of the theme being tested through their activities. Outcome measures

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Three measures were used to assess individual change, the Social Skills Rating System (SSRS), the Self Image Profiles (SIP), and the Coopers- mith Self-Esteem Inventories (CSEI). All meas- ures when administered, were read aloud to each child.

The Social Skills Rating System, (SSRS) (Gre- sham & Elliott, 1990) was developed in the United States of America to assess social beha- viours of children 3 to 18 years using three rat- ing report forms, parent, teacher, and student, with separate forms for preschoolers, primary age children, and adolescents. The instrument consists of three scales, the Social Skills Scale on all report forms, the Problem Behaviors Scale on the parent and teacher report forms, and the Academic Competence Scale on the teacher re- port form only. For this group work intervention, the teacher and student forms only were administered. The reliability and validity of the SSRS has been reported extensively by the authors, report- ing high reliability for the total scores across Teacher, Parent and Student Forms. The Teacher Forms showed the highest degree of reliability, internal consistency, coefficients and test-retest correlations ranging from .82 to .95, followed by Parent and Student forms. Several methods were used to test construct validity. Items were found to intercorrelation highly with median internal consistency reliabilities (coefficient alpha) of .90 for Social Skills, .84 for Problem Behaviors, and .95 for Academic Competence on the Teacher Form. While not as high, there was evidence of convergent and discriminant validity across teacher, parent, and student raters (Social Skills total 0.31, p<.001 for teacher & parent ratings; 0.32 p<.0001 for teacher & student ratings; 0.24 p<.001 for parent & student ratings). The second measure of individual change was the Self Image Profiles (SIP), a brief self report measure with separate forms for children and adolescents, providing both a visual display of self image and self-esteem. The theoretical ra- tionale behind the development of the profiles is based on the notion of self as a personal con- struction, the child‟s sense of self is considered an interpretative act (Butler & Green, 1998). The SIP-C provides a measure of Self Image by ask- ing the child to first rate the „Actual Self‟ by in- dicating „How I am‟ against each of the 25 items using a 0-6 Likert type scale. Measures of Self Esteem are achieved by then asking the child to rate the „Ideal Self‟ by indicating „How I would like to be‟ against the same 25 items using the same Likert scale. The discrepancy scores be- tween „How I am‟ and „How I would like to be‟ provide an estimate of the child‟s self-esteem (Butler & Green, 1998; Harter, 1999). Standardisation and validation of the children‟s form (SIP-C)involved 513 school children in Leeds, England. Constructvalidity was determined by comparing the SIP-C with the SelfPerception Profile for Children (SPPC) developed byHarter (1985). The significant relation- ship (p<.01), betweenthe two measures indicated the SIP-C self image andself-esteem scores were measuring the same theoretical con-struct of self identity or concept as the SPPC. Reliability of theSIP-C was explored and self consistency was found for bothPositive Self Im- age and Negative Self Image (p<.01, 2-tailed). Internal consistency using SIP-C intercorrelationshowed Positive Self Image largely concerned with „social‟,„academic‟, „outgoing‟, and „appearance‟ aspects of self, whileNegative Self Image was made up with „behaviour‟, and„emotional‟ aspects of self (Butler, & Green, 2001). The third measure of individual change, the Coopersmith SelfEsteem Inventories (CSEI) (Coopersmith, 1981), is a widelyused measure of evaluating self-concept (Peterson, 1985;Se- well, 1985), with school-age children and adults.Coopersmith (1967) defined self-esteem as a personajudgement of worthiness that is ex- pressed in the attitudeschildren hold of them- selves. This instrument, a brief self-report ques- tionnaire, assesses attitude toward one self ingeneral, as well as in social (peers), academic (school), andhome (parental) contexts. The child is asked to mark “like me”or “unlike me” on a set of 58 favourable or unfavourablestatements about the child. The rationale behind thedevelopment of this measure is that the construct of self-concept merges with certain related con- structsdesignated as self-esteem (Coopersmith, 1967, 1981). Thereliability, stability, and con- struct validity of the questionnairehas been sup- ported by considerable research (cited by Coo-persmith, 1981).

The Group Session Evaluation (GSE) (see Table 2), formingpart of the structure of the sessions and serving as anoverview and review tool at the end of each session, wascompleted by the group members. Considerable research hasbeen undertaken into the efficacy and effectiveness ofpsychotherapy (Lambert & Ogles, 2004; Miller, Duncan, &Hubble, 2004), and tools have been developed to measurecounselling processes and outcomes. Inspired by theseinvestigations, the GSE was developed to follow andrecord the group processes and group work outcomes,through the evaluations of the group session by the child. TheGSE was designed to investigate the self descriptions of thechild, and how the child rated herself or himself in termsof the supplied construct developed from the group workgoals.

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Table 2: Group session evaluation. NAME:

DATE: SESSION:

Now, I am feeling and I am thinking Now, I am feeling and I am thinking Developed over three years through pilot studies, the current GSE measure has 5 supplied constructs and an ordinal scale of „Yes‟, „A Bit‟, and „No‟. At the beginning and at the end of the session, the group members were asked to write down how they were feeling and thinking, “Now, I am feeling…and I am thinking….” At the end of the session, they were asked to indicate how they experienced the session by evaluating the session using the supplied constructs.

DESIGN

The data from all the group work interventions were pooled, and there was no examination to determine if there were any differences in out- come measures and group processes between the groups. This decision was taken because of the small size of the sample, and the differences in total number of sessions. A repeated-measures design was used to analyse data collected before the group work began (Time 1), and when the group work ended (Time 2), for each dependent measure, and to test the differences in the means. Descriptive statistics (number of responses, percentages) were calculated, to show the evaluations by the members of the group work process outcomes. The analyses of the data used the total raw scores for the different scales on each of the measures. For the CSEI, the total raw score was only used in the analysis. Currently, data are be- ing collected to evaluate the group work intervention twelve months later (Time 3).

RESULTS

Retention rates were good (93%), with one memberleaving to attend a school in another region. Changes in Social Skills The data from the SSRS were analysed at Time 1and Time2 using the Paired Samples Tests. While there was asignificant increase in Social Skills reported by the teachers(t= 2.188, p< 0.025, one-tailed), a small to medium effectsize of 0.4 (Time 1, M= 86.9, S.D.= 8.62; Time 2, M= 90.6,S.D.= 10.52), the students, however, did not report asignificant increase. The data from the SSRS-Teacher alsoreported a signifi- cant decrease by the students in ProblemBeha- viors (t= 1.136, p< 0.10, one-tailed), with a me- diumeffect size of 0.6 (Time 1, M= 120.4, S.D.= 9.01; Time 2, M=114.9, S.D.= 12.81). The data from the SSRS-Teacher on Academic Compe-tence, reported a small increase in academic per- formanceby the students. Changes in Self-Esteem The Paired Samples Test was used to analyse each of theeleven scores provided by the data of the SIP-C. Theparticipants reported a significant increase in Positive SelfImage (t= 1.372, p< 0.10, one-tailed), a small to mediumeffect size of 0.3 (Time 1, M= 46.4, S.D.= 14.95; Time 2, M=50.1, S.D.= 12.18), and a significant de- crease onNegative Self Image (t= 1.529, p< 0.10, one-tailed), amedium effect size of 0.5 (Time 1, M= 38.8, S.D.= 13.11;Time 2, M= 32.4, S.D.= 17.04). While there was an increasein positive responses on Outgoing (aspect of Self Score), witha 0.4 medium effect size (Time 1, M= 13.3, S.D.= 3.88; Time2, M= 14.7, S.D.= 4.91), it was not significant. The membersalso responded with a significant decrease on Resourcefu(aspect of Self Score), (t= 3.101, p< 0.005, one-tailed), with avery large effect size of 1.24 ( Time 1, M= 5.4, S.D.= 1.45;Time 2, M= 3.6, S.D.= 2.14), indicating at Time 2, they werenot feeling as easily bored as they were at Time 1. The datafrom the SIP-C also indicated that at Time 2, the participantswere „liking more the way they looked‟, Appearance (aspect ofSelf Score). There was a significant increase (t= 2.066, p<.01, one-tailed), with a moderate effect size of 0.64 (Time 1,M= 3.1, S.D.= 2.02; Time 2, M= 4.4, S.D. =2.06). The Paired Samples Test was also used to analyse thedata from the second tool used to measure changes in self-esteem, the CSEI. There was a significant increase in self-

Yes A

Bit No 1. Today I felt others listened

to me. 2. Today I felt others were

nice to me.

3. Today I understood more

about me.

4. Today I felt more strong

about myself. 5. Today I felt better about myself.

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esteem at Time 2 when compared to the self reports at Time 1 (t= 3.143, p< .005, one-tailed), with a large ef- fect size of 0.8 (Time 1, M= 50.8, S.D.= 16.80; Time 2, M= 64.1, S.D.= 19.41). Changes in Group Processes The analysis of the members responses on the GSEs was undertaken by pooling the responses to the two categories „Yes‟ and „A Bit‟, and comparing these responses over time, first Session of the intervention (First Session), middle Session of the intervention (Middle Session), and last Session of the intervention (Last Session). Percentages were calculated at First Session, Middle Session and Last Session for each of the five constructs (refer Table 3). The analysis of the members‟ responses (Paired Samples Test) supported the hypotheses, with evaluations ranging from 60-93% of students giving a positive rating on the five supplied constructs at the end of each session. However, the GSE revealed no overall significant increase in positive responses at Time 2 compared to Time 1. Table 3 The number and percentages of the group members’ evaluations of the group sessions at First Session, Middle Session, and Last Session, Rated as ‘Yes/ A Bit’, using the Group Session Evaluation.

Construct First Session

N %

Middle Session

N %

Last Session

N % 1. 14 93 13 87 12 80 2. 14 93 13 87 11 73 3. 9 60 9 60 11 73 4. 10 67 10 67 11 73 5. 12 80 10 67 11 73

DISCUSSION

Personal construct small-group work was found to be effective with primary school students. The results demonstrated that there was an increase in positive social skills as reported by the teachers of the participants. Evidence was also gained from the teachers‟ reports that the participants after the group work were engaging in fewer problematic behaviours. Together, these measures demonstrate a consistent direction, suggesting the intervention had an overall positive impact. While the teacher‟s judgements were not blind, this positive direction could also be demonstrating construct validity in the test construction. Although, the participants themselves only reported a small increase in positive social skills at the completion of the group work, they did report increases on the measures of self image and self-esteem. The participants reported they felt more positive and less negative about them- selves after the groupwork. By identifying themselves more positively after groupwork, they reported they felt more resourceful, and likedbetter the way they looked. Supporting these reports offeeling more positive about themselves, were also reports bythe participants of positive increases in their self-esteem afterthe group work. These increases in self-esteem whilenot consistently reported across all the measures ofself-esteem, were significantly strong on one of themeasures of self-esteem (CSEI). While the group evaluation sheets were able to capturethe students‟ immediate positive reactions to the groupsessions, they were not able to track the impact, thechanges in social skills and self-esteem were possiblyhaving on the group processes. The students‟ responsesindicated that the group sessions on the whole werepositive and enjoyable, and most times they felt they belonged to the group and were understood, that the groupmembers listened to them, and they felt stronger inthemselves, and more self- confident. While the results are encouraging, there are a number odesign problems which need to be discussed. One othese problems relates to the population of students. Theinequitable gender and age distributions, is one suchdifficulty, oth- ers are the differences in the number osessions, and the varying lengths of the interventionsRunning groups across three different schools alsointroduces unknown variables which could possiblyconfound the results. There are also the problemsassociated with using a model rather than a manualisedapproach. However, useful data were collected fromthe group members through the Group SessionEvaluation at the end of each session, which providedsome validation that the intervention was compatiblewith the group work goals established by Kelly‟s (1991bassumptions of personal construct group psycho- therapyData collections at Time 3 are not avail- able to providefurther support for the effective- ness of the interventionFinally, the group work intervention has not beencompared with other psychological approaches. Thesedesign prob- lems influence the power of the findings, thegeneralisability of the results, and question theirrepresentativeness. CONCLUSIONS The research has shown that small-group per- sonaconstruct counselling is a useful and effi- caciousintervention, which improves the psy- chologicafunctioning of primary school stu- dents. It is also anapproach that can be underta- ken in a school setting by

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the school counsellor. Future investigations are needed to overcome some of the design problems in this research, and to account for other factors which have been shown to contribute to effective interventions such as, counselling method (Nathan & Gorman, 2002), the counsellor (Wampold, 2001), the counselling relationship (Norcross, 2002), and the client, the students (Bohart & Tallman, 1999). Future focused research and programme evaluation is needed to endorse evidence-based group interventions with children REFERENCES Auger, R.W. (2004). Evaluating school-based coun- selling groups. School Social Work Journal,29(1), 55-69. Aurelio, K.J. (2004). A program evaluation of a school-based counselling group for elementary school children. Abstracts International Section A: Humanities and Social Sciences, 64(9-A),3186. Akos, P. (2000). Building empathic skills in elemen- tary school children through group work. Journal for Specialists in Group Work, 25(2), 214-223. American Psychological Association. (1997). Learn- er-centered psychological principles: A frame- work for school redesign and reform. Washington, DC: Retrieved November 28, 2001, from http://www.apa.org/ed/lcp.html American Psychological Association (2006). APA 2005 Presidential Task Force on Evidence-Based Practice. American Psychologist, 61(4), 271-283. Barrett, P.M., & Shortt, A.L. (2003). Parental in-volvement in the treatment of anxious children. In A.E. Kazdin, & J.R.Weisz (Eds.), Evidence-based psychotherapies for children and adolescents (pp.101-119). New York: The Guilford Press. Barrett, P.M., & Turner, C. (2001). Prevention of anxiety symptoms in primary school children: Preliminary results from a universal school-based trial. British Journal of Clinical Psychology, 40, 399-410. Bohart, A., & Tallman, K. (1999). How clients make therapy work: the process of active self-healing. Washington, DC: American Psychological Association. Butler, R.J., & Green, D. (1998). The child within: the exploration of personal construct theory with young people. Oxford: Butterworth Heinemann. Butler, R.J., & Green, D. (2001). The self image pro-files fochildren (SIP-C) & adolescents (SIP-A). Manual. LondonThe Psychological Corporation Limited. Campbell, C. (2003). Student success skills training:AnAdlerian approach to peer counselling. Jour- nal oIndividual Psychology, 59(3), 327-333. Coopersmith, S. (1967). The antecedents of selfesteem. USA: W.H. Freeman & Co. Coopersmith, S. (1981). SEI. Self-Esteem Inventories. Palo Alto, CA: Consulting Psychologists Press, Inc. Cousens, C. (1999). Therapeutic space and containmenin group work with delinquent adolescents. The ChildPsychoanalytic Gazette, 11, 3-21. Crespi, T.D., Gustafson, A.L., & Borges, S.M. (2005). Group counselling in the schools: Considerationsfor child and family issues. Journal of Applied SchooPsychology, 22(1), 67-85. Department of School Education. (2006). TheDepartment: Statistics and information. N.S.W.Australia. Retrieved June 12, 2006, fromhttp://www.dse.nsw.edu.au. DeRosier, M.E. (2004). Building relationships andcombating bullying: Effectiveness of a school- basedsocial skills group intervention. Journal of Clinical Childand Adolescent Psychology, 33(1), 196-201. Gresham, F.M., & Elliott, S.N. (1990). Social Skills RatingSystem. Manual. Circle Pines, MN: Amer- ican GuidanceService, Inc. Harter, S. (1985). The self perception profile fochildren: Manual. Denver, CO: University of Denver. Harter, S. (1999). The construction of the self: a developmental perspective. New York: Guilford Press. JacksonS.R. (1992a). Self-Characterisations: devel- opment anddeviance in adolescent construing. In P. Maitland, & DBrennan (Eds.), Personal con- struct theory, deviancy andsocial work. (pp. 60- 68).