Counselling in the third sector: to what extent are older adults accessing these services and how complete are the data third sector services collect measuring client psychological distress?

Abstract

Background: A low number of older adults access Improving Access to Psychological Therapies (IAPT) services in England. Barriers include ageism and stigma. Routine outcome measures (ROMs) assess the effectiveness of counselling, although counsellor and service-level barriers prevent uptake. Aims: Access rates of older adults to third sector (sometimes called voluntary or community sector) counselling and psychotherapy services were explored. The extent of ROM collection on psychological distress was assessed. Methodology: Data collected between 2018 and 2019 were pooled across six third sector counselling services in England, Scotland and Northern Ireland (N = 2,757). Access based on age and gender was assessed, and the chi-square analysis was used to compare gender distribution within the age groups. Availability of pre- and post-therapy ROMs was assessed, and the chi-square analysis was used to explore the age and gender differences in completion. Findings: Lower access rates in people aged 65 and over (4.4%) were found compared with IAPT (7%). Access rates decreased further as age increased. Access of people aged 50 and over (24.5%) was below the 34.6% of the population in this age category. A third of people accessing counselling in all age groups were men. Only 28.6% completed a pre-therapy ROM, and 29.5% of those clients subsequently completed a post-therapy ROM. Implications: Mental health promotion and adapting communication during counselling may help engage older adults and men in counselling. Training on working with older people and long-term conditions is also beneficial. Support in using ROMs can improve uptake although organisational barriers may restrict implementation in the third sector.