ANNUAL REPORT April 2022 – March 2023 Presented to the Board of Trustees at the AGM 24[th] April 2023 ## Table of Contents **Table of contents……………………………………………………………………………………………… …………………………..1** **Introduction from the Chair 2** **Financial** **Report………………………………………………………………………………………………… ………………………….3** ## **Data** **review………………………………………………………………………………………………… ………………………………..3** General findings 4 Figure 2: Client issues 5 Outcome measures 6 **Counsellor Reviews 7** Achievements 7 Issues 7 Support 8 Goals 8 Training 8 Improvements 8 **Trustee Reviews 9** **Action Taken Since Reviews 10** **Safeguarding 10 Client Feedback 11** Selected Client Comments 12 Suggested Improvements 13 **Future Endeavours 13** 1 ## **Counselling at AFC** # **Annual Report for the AGM** ## **22nd April 2023** ## **Introduction from the Chair** The past year has seen a good growth within the agency; 21 clients as opposed to 9 clients the previous year. This has been through advertising with a free subscription at The Counselling Directory and through AFCC tv screens. There was also some clients from word of mouth from clients to family and friends. The new website is almost ready to launch which, hopefully will bring in more clients. This is mainly down to Toby’s hard work. Toby has also spent hours working on new policy and procedure documents. Many thanks Toby for this and so much more that you do for the agency. These documents and new policies future proof the service for taking on trainees or new counsellors and address the more complex clients we are seeing. I have stepped back from client work which enables a focus on finances, committee and communication, assessments and allocation of new clients. Many thanks to Jane for being my partner in all that I do. Thanks again to Toby for stepping up to be a Trustee and joining Pat, Gill, Denise, Jane and myself. After Jane and I met with Penny, church elder and Shirley, church treasurer, it was agreed for a voluntary donation of £245 to be paid from us as a contribution for the year room hire. This is roughly 10% of our balance at the end of the financial year. We are also in the process of completing room hire forms. A card reader has recently been set up to help prompt immediate client payment. A new App is being trialled by the counsellors for tracking this and room bookings. AFCC had an open day in which the service was advertised and promoted by all counsellors, including Toby offering free group mindfulness sessions, which was well used. It is exciting to see how we have grown and continue to support each other very well. We are a good team! Thanks to you all for your continued time, effort and enthusiasm to our agency. I am optimistic we will continue to bond and grow together creating greater outreach for the community. I am very grateful 2 Sue ## **Financial Report** The income and expenditure have steadily grown over the past year, income in April 22 was £245 with £249.50 expenses compared to Feb 23; income £806.96, expenses £661.20. The main income is client donations and expenditure is mainly counsellor invoices. The balance increased from £1,055.96 in April22 to £2,437.19 at the end of the March23. This has enabled us to take on low-cost clients, donate to AFCC for room hire and buy insurance protection amongst other things. Looking ahead we hope to expand into businesses, offer group courses and expand the number of counsellors. |and expand the number of counsellors.|and expand the number of counsellors.|and expand the number of counsellors.||| |---|---|---|---|---| |**Summary Apr22-Mar23**||||| |**Summary**|||**Bankbalance**|| |**Income**|**£5,524.4**
**5**||**Balance**
**b/f**|**£1,055.9**
**6**| ||||**Surplus**|**£1,381.2**
**3**| |**Expendit**
**ure**|**£4143.2**
**2**|||| |**Surplus**|**£1,381.2**
**3**||**Balance**
**c/f**|**£2,437.1**
**9**| ## **Data Review** Data covers the Period from 1[st] April 2022 to 31[st] March 2023. ||Current
Year
(Apr
22-23)|Previou
s year| |---|---|---| |Numberof individualclients seen|21|9| |Numberof newclients|18|9| |Numberofscheduled sessions|217|96| |Numberofdelivered sessions|190|86| |Numberofcancellations|20|9| |Numberof DNAs (DidNot Attend)|6|1| |Average Sessions Attended (for
completed clients)|11.5|9.7| 3 **----- Start of picture text -----**
35
30
25
20
15
10
5
0
Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 Mar-23
Sessions (22-23) Last years (21-22)
**----- End of picture text -----**
## Figure 1: Number of session per month ## General fndings - The number of sessions and new clients seen has more than doubled this year, reflecting the growth of the service - There has been a corresponding increase in cancellations and DNAs, which represent 4.6% of scheduled sessions. This is down from 10.4% the previous year. Most cancellations were in December. - Most clients complete the full 12 sessions offered. It should be noted that the average reflects a few clients finishing fewer than half of the session and some being offered extensions. - The trends in sessions per month roughly match the previous year. It is notable that there is peak in sessions in January this year, perhaps linked to financial pressures caused by the economy. A peak in July was followed by a drop possibly due to not taking on new clients due to the church closure for maintenance work. - No new couples were seen this year, but this is mostly due to restricted counsellor availability. 4 Figure 2: Client issues % Current year % Last year **----- Start of picture text -----**
14
12
10
8
6
4
2
0
%
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5 Considering the issues being brought by clients (Figure 2), it can be seen that the trends are again similar to the previous year. There is a wider range of issues, reflecting the greater number of clients. These are the top 10 issues presented (those in brackets are from last year): 1. Relationship issues (Relationship issues) 2. Anxiety (Anxiety) 3. Depression (Issues with children) 4. Stress (Depression) 5. Low self-esteem (Family) 6. Family (Stress) 7. Feeling more positive (Eating issues) 8. Eating disorders/Disordered eating (Bereavement) 9. Social isolation (Significant life changes) 10. Suicide/Suicidal ideation (Work issues) The issues are fairly similar for the two years. However, it should be noted that suicidal thoughts are far higher reflecting the increased complexity and risks associated with newer clients. Social isolation is also new on the list, which is perhaps surprising given that society has mostly moved on from Covid. It is encouraging that “Feeling more positive” is so high on the list this year, as this reflects the excellent work being done with clients. ## Outcome Measures At the beginning, middle and end of the set of sessions, clients compare a range of outcome measure forms. Sometimes the scores will increase in the middle sessions, but this often reflects the fact that issues are being processed. The following measures are completed: CORE 10 – measuring general wellbeing, functioning, problems and risk. A score of 10/40 is the clinical cut off for the general population. PHQ9 – Used to measure depression symptomology GAD7 – Used to look at anxiety symptomology The data in the following table is based on 14 clients who completed a start and end set of forms. ||RANGE
AT
START|RANGE
AT END|MEAN
START|MEAN
END|MEAN
CHANGE| |---|---|---|---|---|---| |CORE
(/40)|3-25|0-20|16.1
(Moderate)|8.0 (None)|- 8.4| |PHQ9
(/27)|1-20|0-16|12.6
(Moderate)|4.6 (Just
Mild)|- 8.5| |GAD7
(/21)|1-19|0-12|11.2
(Moderate)|4.8 (Just
Mild)|- 6.7| 6 ||MEDIAN
START|MEDIAN
END|MEDIAN
CHANGE|
It can be seen
from the data
that for all
measures the
counselling| |---|---|---|---|---| |CORE
(/40)|17
(Moderate)|5.25
(None)|- 8|| |PHQ9
(/27)|13
(Moderate)|3 (None)|- 10|| |GAD7
(/21)|10
(Moderate)|3.5 (None)|- 5|| - reduces the scores. For the CORE forms a change is 5 points is considered clinically significant. - Clients are coming in on average with Moderate difficulties and symptomology and leaving with, on average, no issues beyond those of the general population. - It should be noted that the ranges of scores reaches ‘Severe’ levels on all scores, but the range for each is also lowered to moderate levels for the CORE and GAD7, and ‘Moderate/Severe’ for the PHQ9. ## **Counsellor Reviews** Counsellors were positive about the review process, as it gave them an opportunity to reflect on the past year, offered them a reminder of why they do this role and how much they enjoy it. Their responses really showed how supportive everyone is and it’s also a good way to re-connect with the trustees. Counsellors have seen between 2 and 8 clients each this year. Usually between 1 and 4 clients are seen a week by each counsellor. ## Achievements All the counsellors recognised their significant achievements over the last year, both professionally and personally. All found they did well to take on the new challenges in their roles as the charity was setting up and starting to receive clients; including administration, assessing new clients, managing time effectively, using new skills from recent training, seeking the support of the team and the trustees, responding to their team’s needs and getting used to a brand new set of policies and procedures. ## Issues Issues which could have gone better consisted of mainly administrative and practical issues which have arisen as a result of this being a new experience for everyone e.g., data handling, feedback forms, handling last minute cancellations and requests for low cost counselling were mentioned. It was also challenging at first when counsellors were adjusting their working style to accommodate 12 weeks of sessions as opposed to working with an open ended number of sessions. 7 Some difficulties have arisen this year including: - Minor payment issues, hopefully resolved by offering a payment facility - Minor attendance issues of clients - Communications with Church staff have had a few hiccups e.g., signing in and out/being locked in/parking difficulties which affect both counsellors and clients. - When necessary, stepping back from client work and looking after oneself, although difficult, was made easier with the support of the whole team and knowing their clients were looked after and treated professionally. - General practical issues have been challenging at times, but again support from others and clarification from the board has been valuable. ## Support Every counsellor mentioned the support they get from each other as being invaluable. It was clear that their monthly meetings have been productive and very much appreciated by all. Counsellors have also been there for each other between these meetings. Counsellors also mentioned that the trustees, their supervisors and the Church have been accessible and helpful. ## Goals Counsellors identified the following personal goals for next year: - Setting up group sessions - Co-delivering workshops to groups and businesses - Marketing to businesses - Increase the number of clients, both for individual and couples work - Broaden the types of clients they work with - Continue with professional development training to enhance client work - Improve the system for last minute cancellations via emails and telephone calls ## Training With regards to CPD and training, the following issues were raised: - Safeguarding training would be welcomed - All counsellors felt they are choosing appropriate training themselves, however this can be expensive - Some have found free learning due to being in a voluntary position - The counsellor’s group does a good job of recommending courses and sharing knowledge gained 8 ## Improvements All counsellors felt the trustees are supportive and accessible and are fully behind the growth of the charity. They identified the following ways that support could be enhanced: - A couple of sub committees to work on specific areas. E.g., marketing to target businesses and set up workshops; and one for practical decisions regarding counsellor’s requests for things like low cost counselling, student counsellors, number of sessions etc. - Annual meal to touch base with the board and connect us all The following ways to improve the service have been suggested: - Find a better way for clients to communicate with counsellors about bookings, in particular last minute cancellations. Messages and emails aren’t always accessible when this happens so it can leave both parties in the dark. - Get businesses on board so we can start offering workshops, bring in paying clients, EAP work etc. - Consider offering placements for trainee counsellors - Possibly take on another qualified counsellor - Use of a team diary which everyone can access - Offer group work - Find ways (and time to) share resources, CPD training with other counsellors where appropriate - Continue to grow, and market ourselves in the area ## **Trustee Reviews** All trustees took part in the review except for Toby Payne, who had not been in post for a long enough period of time to warrant giving feedback. All actions were up to date, except for one involving the complaints procedure to be resolved by the AGM. Trustees feel that communication in the group is good and that they act as a collaborative team who have regular meetings. There is always someone to ask for help and answer questions. There has been a lot of hard work put into establishing this worthwhile and functioning charity which reaches local people to provide low cost counselling. The future looks exciting and bright as the service continues to develop. Trustees felt they have been able to conduct their roles well, especially in the following ways: - Attending meetings - Supporting counsellors - Expressing views and ideas - Joining subcommittees - Supporting other trustees 9 - Keeping banking up to date - Preparing paperwork and agendas Some areas were identified as potentially being improved: - Following action points up earlier - Being aware of an upcoming meeting to prepare in good time - Not leaving organising paperwork for meetings to the last minute - Making sure emails are responded to promptly - Some members are unable to attend online meetings due to IT issues - Going forward a WhatsApp group would be useful In order to enhance things in the organisation trustees feel it would be useful to explore general training opportunities with the National Council of Volunteer Organisation and also 31:8 for safeguarding training. Banking and treasury issues have been challenging at the start, but this procedure has been simplified in line with changes made to overall data collection. Trustees would like to expand the service into businesses, explore fundraising activities and possibly offer a placement to trainee counsellors. ## **Actions Taken Since the Reviews** Following this review, the following actions have been taken which address some of the issues raised: - A card reading machine has been purchased and is available to take in-session payments - An online diary system has been set up to book sessions and monitor when clients have attended - Session notes forms have been amended to eliminate the need for monthly data sheets to be filled out. This has greatly streamlined the process. Issues codes are now also in the rooms which helps with data collection - Subcommittees have been set up. One is to manage decisions around low cost counselling and offering additional sessions, and the other is to look at fundraising opportunities. - There has been an offer from a trustee to offer safeguarding training to counsellors and trustees - A trustee WhatsApp group has now been set up ## **Safeguarding** The team of counsellors work within safeguarding guidelines and are appropriately trained in maintaining the safety of their 10 clients and others using the building. Safeguarding is a standing item at committee meetings. The safeguarding trustee has met with the counselling team to discuss the Church’s policy document and where it is displayed, and the system in use at Adeyfield Free Church to report any observed Safeguarding concerns. This is supplementary to the organisation’s own safeguarding policies for Adults and Young People which were updated in November 2022. It was agreed that any future Safeguarding training offered by the church would be offered to members of the counselling team. ## **Client Feedback** We received 5 feedback forms this year. All have provided consent for use of comments in reports. In order to gain more responses there are now online versions of the forms available to send to clients at the end of the therapy. For the first section of the form all clients agree with the following statements: - I got the information I needed - I got the support I needed - I felt my concerns were understood - I felt comfortable with the way in which the counselling was provided - The environment was safe and welcoming - I valued the centre’s service - The support was sensitive to my needs and situation All clients rated the venue and location as Excellent. Having parking was valued. All clients agreed with the following statements: - I have a better understanding of my situation and I know what I can do about it - I understand more about how my circumstances have affected me - I have been able to make decisions about my future. Not all clients required access to other support services and so this was not applicable. 11 **----- Start of picture text -----**
Feel in control of emotions
Feel close to people who matter
People around that I trust
Positive coping skills
Taking good care of myself
Good about myself
Confident in myself
Make every day decisions
0 1 2 3 4
Number of Clients
Strongly Agree Agree Disagree
Qualities at end of therapy
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The graph shows that clients agree that they developed the displayed qualities after the counselling. Most clients agree with the feelings that things are better for them. Some clients still did not feel good about themselves or in control, but many clients have come with complex issues and so the presence of agreement in the other areas is a positive sign. Other reported benefits included: - Putting boundaries in place - Less procrastination - Better focus - More positive outlook - Feeling happier - Take time for themselves - Learnt to say how they feel - Listen more to others ## Selected positive comments “My counsellor was wonderful” “We worked very well together and connected which is very important and advised me and went through strategies too” “It got me through a very difficult time in my life” “I felt that it addressed my specific issues and re-established my faith in the process of counselling” “I had an excellent therapist who understood my situation and how to help me” 12 “The appointment was given very quickly and I received a very good sensitive support” “I now understand why my depression led to certain behaviours. Helped my relationship with my child and others” “At a crossroads in my life... I had exhausted the counselling available through my GP. With limited income I felt stuck with nowhere to turn until I heard about AFC counselling. This has been the most helpful counselling I've ever had and really enabled me to make the changes my life needed. Thank you” “Fantastic support and understanding…My personal wellbeing has improved to a remarkable degree” “I did not know how much I needed the sessions until after the 12 sessions. I can now look back and see what a difference it has made to me and my family. Thank you” “At the start of this process I was feeling very low but wanted to engage so that I could feel better. I now feel much more like me before some of the traumas. Life feels easier and I understand that some of my experiences have been out of my control” “The experience…very warm. I felt I was taken seriously and also listened to…. I felt I could be myself. The counsellor kept her professionalism throughout and also saw when I needed empathy… We went through some strategies to help me” “Thank you for working with me in such an effective and compassionate way” “I would definitely come back again and would recommend it to other people” ## Suggested improvements “Remove the 12 session rule” “I feel there should be more sessions available instead of just 12 for the people that feel they need more sessions to talk about any issues that have not been discussed or solved” It is clear that some clients feel that there are not enough sessions. This number has been chosen as it represents 3 months of working together and is twice as many sessions as other similar services. Clients have the option to return after three months and extensions are possible if there is a significant clinical need. ## **Future Endeavours** 13 Counselling at AFC is always looking forward to develop the service and so the following are projects and initiatives which the trustees are keen to explore over the next 12 months: - Approach businesses to offer EAP or other support work to employees and increase revenue to offer more low cost sessions - Subcommittee to explore possible funding or grant opportunities - Look at the possibility of offering group sessions - Consider taking on a new contracted counsellor to offer more sessions - Consider offering a student placement to offer more sessions - Explore membership of the National Counselling Society further 14