"PubL Mhh, Loud. (1979)93, 39--41
Youth Counselling in a Hea.lth Authority Lyn Corn/ B.Sc. (Sociology). Cert. Mental Health
Kingston and Richmond A./-/.A., Department of Community Medicine and Hea/th, King's Road, Richmond, Surrey TWtO 6EF Introduction In 1969 the Richmond Youth Counselling Clinic was established by Richmond Health Department under the Local Authority Family Planning Act, 1968. The clinic's inception was a response to anxiety amongst.the medical profession concerning the after care of young girls following the termination of pregnancy. Contraception and counselling were to be available, and there was hope that counselling could be extended to include the range o f personal problems which worry young people. Structure of the Clinic There is a staff o f three; a doctor who is a consultant psychiatrist and who is also family planning trained; a nurse/receptionist and myself as social worker, also helping to run the clinic and liaise with other agencies. D r Faith Spicer hdped us establish the clinic in its early years and we still have informal links with the London Youth Advisory Centre where she is Director. The Clinic has a weekly evening session. There is an appointment system which gives our evenings a loose structure, since our clients frequently turn up the week after their appointment, and young people who drop in without appointment are nearly always seen. The Growth o f Youth Co|reselling Over the last ten years, -there has been a rapid growth in Youth Counselling Centres. The sparseness o f such Centres is commented on in articles of the time. Laufer-*, talking about his recently formed Young People's Consultation Centre at Brent, said " . . . . there is no organization where a professional person is available to talk to any young person who comes in". The Directory o f Voluntary Counselling and Allied Services (1977) 2 now lists 50 such agencies for young people and there are many more services unlisted, the British Association for Counselling has a special section for Young Peoples Counselling and Advisory Services to bring these agencies-together and encourage their development. The first counselling services specifically for youngpe0ple were in the universities. McKeith 3 said of his and Malleson's experience in the Student Health Service. . . . "There is little doubt that rewarding opportunities .for preventive and treatment services exist among our adolescents, the academic 20 ~o get a service, who will speak for the 80 ~oThe development of youth counselling has been a response to the growth of the youth culture which has changed young people's place in society today. Independence from the family and identification with their peers, involving them in a different life style from the adult world, is a goal for teenagers long before emotional and economic independence is within their grasp. 0038-3506/79/010039+~03 $01.00/0
(_~ 1979 The SOcietyof Community Medicine
L. Cot13'
40
Their attempts to emancipate themselves from family life often lead lhem into situations beyond their experience ~vhen they are tmwilling to accept parental intervention, though they are often in need of help. Under these circumstances, young people are found to be more attracted to services designed specifically for them rather lhan ~o general ones. Caplan's 4 theory o f crisis intervention is particularly applicable to the structure and goals o f counselling centres. He stated that help .must be available in the early days o f the crisis and to achieve this . . . . "'the threshold between the agencies and community must be lowered". Youth Counselling services .have been set up in various ways to meet the need for a specific service for young people which is speedily available. Many have been sponsored by voluntary bodies, but some have been set up by the statutory services, amongst them a youth department, a child guidance service, an education department and a Health Authority. Some o f these counselling resources have been able to extend their availability, using volunteers with in-service training, ~o man 24 hour telephone services, and to expand opening hours. Often other services are linked in with counselling centres, giving information, medical help including contraceptive advice, and ~egal .advice. Tylor (1978) reviewed these services in a report:for the D.H.S.S. ~She commented on the diversi~y of ways they had originated and on their varied structure linked to variations in their theoretical approach. However she argued that the services which survived were those who employed a paid organizer who provided the essential continuity and drive in t h e project.
Discussion In the early days our ci.~entsreached us by referrals from other agencies; over time t-his had changed so that clients generally come to us on the recommendation o f friends and relatives. Initially, our clients were referred to us by one hospital in the area, following the termination of pregnancy. This referral source dwind led and was replaced in importance by referrals from young people who had attended our clinic. TABLE
Referral source Gynaecologist General practitioner Health department Other agencies Friend/relative Not known Total
1, Comparative figures of new referrals since 1970 1970
1971
1972
1973
1974
1975
1976
1977
4 2 7 16 7 0 36
19 4 5 14 10 0 52
24 4 8 12 24 0 72
5 3 8 3 7 0 26
4 0 3 7 19 0 33
2 0 7 12 29 3 53
1 1 3 24 35 3 67
1 4 8 17 26 2 58
TAnt~E2. New referrals to the clinic January 1976-December 1977 I. Presenting p r o b l e m Contraception Sexual problems Emotional problems Behaviour problems Not known
II. Age.distribution (yrs) 50 3i IO 32 2 125
Under 16 Under 21 Over21 Not known
llI. Means of refeITal 26 81 18 -125
Hospital and General practitioners All other agencies Friend/relatives/self Not known
7 52 61 5 125
Youth counsetlhtg in a tteatth AuthoriO,
41
Today, half of our clients come to us for contraceptive advice; the others for a variety of needs, i.e. practical information; difficulties in family relationships; depression; psychosexual problems, and behaviour difficulties. A number of worried parents consult us about their teenagers behaviourand we sometimes see parents of young people already attending the clinic with their permission. It is interesting to note that extremely rarely are parents contemplating statutory intervention when they bring adolescents to us with behaviour problems, although they often describe their childrens" behaviour in terms that would have justified them coming into the care o f the social services. This suggests both, that we cover a different group o f families :to those seeking reception into care to solve their difficulties, and that we may also be seeing famil.ies at an earlier stage in their problems when there is still some flexibility in the situation; certainly we still see a preponderance o f clients from social classes I and ! I of the RegistrarGeneral's classification, ~ but the proportion from soc~al classes IiI-V is rising gradually. Three different groups of young people who used our clinic can be identified. (I) Those requiring a practical service (2) Those who meet with a crisis and generally require short term help (3) Those whose difficulties ~relate to earlier disturbance in childhood Many of the younger girls who came "Just for the Pill" have difficulties in their relationships with their parents: when they are able to make a positive relationship with our doctor they can explore these difficulties with him, internal tensions can be reduced and consequenlly acting out behaviour, including promiscuity, tends to diminish. Conclusion Youth counselling services have been set up in many large cities over the country, and young people have responded by using their services and referring their friends. The counselling centres are able to make a positive contributio~ towards community menta| health by encouraging young people to ask for help at an early stage in their difficulties when resolution o f their problem is most hopeful. I feel that youth counselling has shown it has a valuable contributior, to make, and suggestthere should now be encouragement from the Department o f Health and Social Security for the provision of a universal network ofcounselling centres.
Acknowledgements I am gra~efut to Dr A. Model, Psychiatric Consultant, and to Dr A. M. Nelson, the Area Medical Officer, for their help .and support. The opinions expressed are mine alone, and not necessarily those of the Kingston and Richmond Area Health Authority.
References 1. Laufer, M. (1963). An experiment in working with adolescents. Reproduced from NewSocieo', In Leicester, J. H. & Farmdale, W. A. J. (Eds) (1967). Trends in the Services for Youth, Oxford: Pergamon Press. 2. British Association for Counselling .(1978). Directory of Voluntary Counselliltg and Allied Services. 3. McKeith, R. C. (1967). The health and illness of the adolescent. In Leicester, J. H. & Farmdate, W. A. J. (Eds) (1967). Trends in the Services for Youth. Oxford: Pergamon Press. 4. Caplan, G. (1964) Principles o f Preventive Psychiatry. London: Tavistock Publications. 5, Tylor, Mary (1978). Adr'isory attd Counselling Services for Young People. Research Report I London: D.H.S.S. 6. Registrar General (1960) Socio-Economic Classification o f Occt&ation. London: H.M.S.O.
Youth Counselling in a Hea.lth Authority Lyn Corn/ B.Sc. (Sociology). Cert. Mental Health
Kingston and Richmond A./-/.A., Department of Community Medicine and Hea/th, King's Road, Richmond, Surrey TWtO 6EF Introduction In 1969 the Richmond Youth Counselling Clinic was established by Richmond Health Department under the Local Authority Family Planning Act, 1968. The clinic's inception was a response to anxiety amongst.the medical profession concerning the after care of young girls following the termination of pregnancy. Contraception and counselling were to be available, and there was hope that counselling could be extended to include the range o f personal problems which worry young people. Structure of the Clinic There is a staff o f three; a doctor who is a consultant psychiatrist and who is also family planning trained; a nurse/receptionist and myself as social worker, also helping to run the clinic and liaise with other agencies. D r Faith Spicer hdped us establish the clinic in its early years and we still have informal links with the London Youth Advisory Centre where she is Director. The Clinic has a weekly evening session. There is an appointment system which gives our evenings a loose structure, since our clients frequently turn up the week after their appointment, and young people who drop in without appointment are nearly always seen. The Growth o f Youth Co|reselling Over the last ten years, -there has been a rapid growth in Youth Counselling Centres. The sparseness o f such Centres is commented on in articles of the time. Laufer-*, talking about his recently formed Young People's Consultation Centre at Brent, said " . . . . there is no organization where a professional person is available to talk to any young person who comes in". The Directory o f Voluntary Counselling and Allied Services (1977) 2 now lists 50 such agencies for young people and there are many more services unlisted, the British Association for Counselling has a special section for Young Peoples Counselling and Advisory Services to bring these agencies-together and encourage their development. The first counselling services specifically for youngpe0ple were in the universities. McKeith 3 said of his and Malleson's experience in the Student Health Service. . . . "There is little doubt that rewarding opportunities .for preventive and treatment services exist among our adolescents, the academic 20 ~o get a service, who will speak for the 80 ~oThe development of youth counselling has been a response to the growth of the youth culture which has changed young people's place in society today. Independence from the family and identification with their peers, involving them in a different life style from the adult world, is a goal for teenagers long before emotional and economic independence is within their grasp. 0038-3506/79/010039+~03 $01.00/0
(_~ 1979 The SOcietyof Community Medicine
L. Cot13'
40
Their attempts to emancipate themselves from family life often lead lhem into situations beyond their experience ~vhen they are tmwilling to accept parental intervention, though they are often in need of help. Under these circumstances, young people are found to be more attracted to services designed specifically for them rather lhan ~o general ones. Caplan's 4 theory o f crisis intervention is particularly applicable to the structure and goals o f counselling centres. He stated that help .must be available in the early days o f the crisis and to achieve this . . . . "'the threshold between the agencies and community must be lowered". Youth Counselling services .have been set up in various ways to meet the need for a specific service for young people which is speedily available. Many have been sponsored by voluntary bodies, but some have been set up by the statutory services, amongst them a youth department, a child guidance service, an education department and a Health Authority. Some o f these counselling resources have been able to extend their availability, using volunteers with in-service training, ~o man 24 hour telephone services, and to expand opening hours. Often other services are linked in with counselling centres, giving information, medical help including contraceptive advice, and ~egal .advice. Tylor (1978) reviewed these services in a report:for the D.H.S.S. ~She commented on the diversi~y of ways they had originated and on their varied structure linked to variations in their theoretical approach. However she argued that the services which survived were those who employed a paid organizer who provided the essential continuity and drive in t h e project.
Discussion In the early days our ci.~entsreached us by referrals from other agencies; over time t-his had changed so that clients generally come to us on the recommendation o f friends and relatives. Initially, our clients were referred to us by one hospital in the area, following the termination of pregnancy. This referral source dwind led and was replaced in importance by referrals from young people who had attended our clinic. TABLE
Referral source Gynaecologist General practitioner Health department Other agencies Friend/relative Not known Total
1, Comparative figures of new referrals since 1970 1970
1971
1972
1973
1974
1975
1976
1977
4 2 7 16 7 0 36
19 4 5 14 10 0 52
24 4 8 12 24 0 72
5 3 8 3 7 0 26
4 0 3 7 19 0 33
2 0 7 12 29 3 53
1 1 3 24 35 3 67
1 4 8 17 26 2 58
TAnt~E2. New referrals to the clinic January 1976-December 1977 I. Presenting p r o b l e m Contraception Sexual problems Emotional problems Behaviour problems Not known
II. Age.distribution (yrs) 50 3i IO 32 2 125
Under 16 Under 21 Over21 Not known
llI. Means of refeITal 26 81 18 -125
Hospital and General practitioners All other agencies Friend/relatives/self Not known
7 52 61 5 125
Youth counsetlhtg in a tteatth AuthoriO,
41
Today, half of our clients come to us for contraceptive advice; the others for a variety of needs, i.e. practical information; difficulties in family relationships; depression; psychosexual problems, and behaviour difficulties. A number of worried parents consult us about their teenagers behaviourand we sometimes see parents of young people already attending the clinic with their permission. It is interesting to note that extremely rarely are parents contemplating statutory intervention when they bring adolescents to us with behaviour problems, although they often describe their childrens" behaviour in terms that would have justified them coming into the care o f the social services. This suggests both, that we cover a different group o f families :to those seeking reception into care to solve their difficulties, and that we may also be seeing famil.ies at an earlier stage in their problems when there is still some flexibility in the situation; certainly we still see a preponderance o f clients from social classes I and ! I of the RegistrarGeneral's classification, ~ but the proportion from soc~al classes IiI-V is rising gradually. Three different groups of young people who used our clinic can be identified. (I) Those requiring a practical service (2) Those who meet with a crisis and generally require short term help (3) Those whose difficulties ~relate to earlier disturbance in childhood Many of the younger girls who came "Just for the Pill" have difficulties in their relationships with their parents: when they are able to make a positive relationship with our doctor they can explore these difficulties with him, internal tensions can be reduced and consequenlly acting out behaviour, including promiscuity, tends to diminish. Conclusion Youth counselling services have been set up in many large cities over the country, and young people have responded by using their services and referring their friends. The counselling centres are able to make a positive contributio~ towards community menta| health by encouraging young people to ask for help at an early stage in their difficulties when resolution o f their problem is most hopeful. I feel that youth counselling has shown it has a valuable contributior, to make, and suggestthere should now be encouragement from the Department o f Health and Social Security for the provision of a universal network ofcounselling centres.
Acknowledgements I am gra~efut to Dr A. Model, Psychiatric Consultant, and to Dr A. M. Nelson, the Area Medical Officer, for their help .and support. The opinions expressed are mine alone, and not necessarily those of the Kingston and Richmond Area Health Authority.
References 1. Laufer, M. (1963). An experiment in working with adolescents. Reproduced from NewSocieo', In Leicester, J. H. & Farmdale, W. A. J. (Eds) (1967). Trends in the Services for Youth, Oxford: Pergamon Press. 2. British Association for Counselling .(1978). Directory of Voluntary Counselliltg and Allied Services. 3. McKeith, R. C. (1967). The health and illness of the adolescent. In Leicester, J. H. & Farmdate, W. A. J. (Eds) (1967). Trends in the Services for Youth. Oxford: Pergamon Press. 4. Caplan, G. (1964) Principles o f Preventive Psychiatry. London: Tavistock Publications. 5, Tylor, Mary (1978). Adr'isory attd Counselling Services for Young People. Research Report I London: D.H.S.S. 6. Registrar General (1960) Socio-Economic Classification o f Occt&ation. London: H.M.S.O.
