One-to-one counselling and school attendance in the UK: a single group pre-post study

Objective: Absence rates remain high in UK schools, with negative implications for attainment, life chances, and inequality. Reasons for non-attendance are complex, but include psychosocial factors. Few UK-based studies have evaluated psychosocial interventions for school attendance outcomes, or its moderators. This pre-post evaluation examined the potential influence of school-based one-to one counselling on school attendance, and possible moderators. Design & setting: Secondary analysis of routine data, collected by a national mental health provider in primary and secondary schools. Participants: 7405 pupils aged 4-19 years, with complete school attendance records at Time1 (pre counselling term) and Time2 (the term when counselling ended). Intervention: All participants received school-based one-to-one counselling with a trained counsellor between August 2016 and December 2019. Outcomes: percentage of school sessions attended (continuous) and persistent absence (binary; attending ≤90% of sessions) in a term. Potential moderators included socio-demographics, mental health, and school engagement/enjoyment. Results: Median Time1 attendance was 96%. 23·6% of participants were persistently absent. The intervention was not associated with improved percentage attendance (0·028%, 95%CI -0·160-0·216) but was associated with 18·5% reduced odds of persistent absence (OR=0·815, 95%CI 0·729-0·911). We identified five moderators of change in attendance (interaction terms p<0.05): age-group (improvements for 4-9s; worsening for 15-19s), and improvement for some ethnicities, and lower parent/carer education. Mental health and school engagement/enjoyment co-varied with attendance in expected directions. Conclusions: One-to-one counselling may improve school attendance among persistently absent pupils, particularly at younger ages. Improving mental health and pupil engagement/enjoyment are potential intervention targets. Our hypotheses require confirmation with controlled designs.