Abstract
Background
The University of Strathclyde Counselling Research Clinic was established in 2007, offering a generalist practice-based protocol (‘PB1’) in which the public could access person-centred therapy for up to 40 sessions. Changes to the research protocol (‘PB2’) were introduced in 2018: a stepped care model with a session 4 review and a 20-session limit. These changes aimed at increasing the clinic’s ecological validity. Two years later, the COVID pandemic fundamentally altered how the clinic operated.
Aim/Research questions
The aim of our study is to assess the impact of those changes on client outcomes, addressing the following research questions:
1. Did the changes introduced in PB2 improve client outcomes?
2. Did client outcomes worsen during the pandemic?
3. Did client outcomes improve following the pandemic?
4. Did the session 4 review improve the quality of the relationship and outcome for PB2 clients?
Method
This study used outcome data (Personal Questionnaire, Strathclyde Inventory, CORE), relational assessment data (Working Alliance Inventory; WAI), and descriptive statistics (number of sessions) to answer these questions. Several analyses were conducted (paired t-tests, multiple regressions) to assess and compare effects (statistical significance and effect size) between protocols and within the PB2 protocol. Ethical approval was granted by the University Ethics Committee.
Results
Contrary to our expectations, differences in client outcomes between protocols were not statistically significant, nor between phases during the PB2 protocol (pre-, during, post-Covid). The therapeutic relationship improved between sessions three and five in both protocols. Measuring at session five was a better predictor of therapeutic outcome than session three.
Limitations
The PB2 dataset is smaller than the PB1 dataset and the data collection process was affected by the sudden move online during Covid. Participants accessing the online service during lockdown may not represent the full range of potential clients.
Equality, Diversity and Inclusion
Research clinic participants tend to be less ethnically diverse than the general population. Barriers may exist for those who struggle with the associated research activities.
Conclusion
Based on our results, it is unclear if the changes in PB2 had a positive effect on client outcome due to the confounding impact of Covid. However, during this unprecedented time, client outcomes and the quality of therapeutic relationships were maintained. Furthermore, outcomes were unaffected by the mode of delivery (in-person, online). Future research will explore clients’ and therapists’ qualitative experiences of the impact of Covid and the protocol changes.
The University of Strathclyde Counselling Research Clinic was established in 2007, offering a generalist practice-based protocol (‘PB1’) in which the public could access person-centred therapy for up to 40 sessions. Changes to the research protocol (‘PB2’) were introduced in 2018: a stepped care model with a session 4 review and a 20-session limit. These changes aimed at increasing the clinic’s ecological validity. Two years later, the COVID pandemic fundamentally altered how the clinic operated.
Aim/Research questions
The aim of our study is to assess the impact of those changes on client outcomes, addressing the following research questions:
1. Did the changes introduced in PB2 improve client outcomes?
2. Did client outcomes worsen during the pandemic?
3. Did client outcomes improve following the pandemic?
4. Did the session 4 review improve the quality of the relationship and outcome for PB2 clients?
Method
This study used outcome data (Personal Questionnaire, Strathclyde Inventory, CORE), relational assessment data (Working Alliance Inventory; WAI), and descriptive statistics (number of sessions) to answer these questions. Several analyses were conducted (paired t-tests, multiple regressions) to assess and compare effects (statistical significance and effect size) between protocols and within the PB2 protocol. Ethical approval was granted by the University Ethics Committee.
Results
Contrary to our expectations, differences in client outcomes between protocols were not statistically significant, nor between phases during the PB2 protocol (pre-, during, post-Covid). The therapeutic relationship improved between sessions three and five in both protocols. Measuring at session five was a better predictor of therapeutic outcome than session three.
Limitations
The PB2 dataset is smaller than the PB1 dataset and the data collection process was affected by the sudden move online during Covid. Participants accessing the online service during lockdown may not represent the full range of potential clients.
Equality, Diversity and Inclusion
Research clinic participants tend to be less ethnically diverse than the general population. Barriers may exist for those who struggle with the associated research activities.
Conclusion
Based on our results, it is unclear if the changes in PB2 had a positive effect on client outcome due to the confounding impact of Covid. However, during this unprecedented time, client outcomes and the quality of therapeutic relationships were maintained. Furthermore, outcomes were unaffected by the mode of delivery (in-person, online). Future research will explore clients’ and therapists’ qualitative experiences of the impact of Covid and the protocol changes.
| Original language | English |
|---|---|
| Publication status | Published - 2025 |
| Event | BACP 31st Annual International Research Conference: Impact through collaboration - Hyatt Regency Manchester, United Kingdom Duration: 15 May 2025 → 17 May 2025 https://www.bacp.co.uk/media/22812/bacp-research-conference-2025-abstracts.pdf |
Conference
| Conference | BACP 31st Annual International Research Conference |
|---|---|
| Country/Territory | United Kingdom |
| Period | 15/05/25 → 17/05/25 |
| Internet address |