ANNUAL REPORT April 2023 – March 2024 

Presented to the Board of Trustees at the AGM 27[th] April 2024 



## Table of Contents 

**Table of contents…………………………………………………………………………………………………………………………..1 Introduction from the Chair** ................................................................................................................... **2 Financial Report…………………………………………………………………………………………………………………………….2 Data review…………………………………………………………………………………………………………………………………..3** General findings .................................................................................................................................. 3 Figure 2: Client issues .......................................................................................................................... 5 Outcome measures ............................................................................................................................. 6 **Counsellor  Reviews** ............................................................................................................................... **7** Achievements ...................................................................................................................................... 7 Issues ................................................................................................................................................... 7 Support ................................................................................................................................................ 7 Goals.................................................................................................................................................... 8 Training ............................................................................................................................................... 8 Improvements ..................................................................................................................................... 8 **Trustee  Reviews** .................................................................................................................................... **8 Action Taken Since Reviews** ................................................................................................................... **9 Safeguarding** ......................................................................................................................................... **10 Client Feedback** .................................................................................................................................... **10** Selected Client Comments ................................................................................................................ 12 Suggested Improvements ................................................................................................................. 12 **Future Endeavours** ............................................................................................................................... **13** 

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## **Counselling at AFC** 

## **Annual Report for the AGM** 

## **27[nd] April 2024** 

## **Introduction from the Chair** 

We are seeing a steady growth in client numbers; 28 this year as opposed to 21 last year. Advertising is mainly through Google and a contact link though our website. We hope to increase our advertising by dropping cards at GP surgeries and relevant notice boards. 

The website is well established, thanks to Toby for his brilliance. Jane & Toby are working on starting group work and we hope to take on a placement counsellor later in the year. This will be a team effort with Toby offering supervision and Jane as line manager. 

The accounts continue to be healthy with a usual balance around £2000 which enables us to offer low cost counselling to those who can’t access our affordable rates. 

A new program called Cliniko is almost ready for counsellors to use. Thanks to Toby for setting it up and trialling. This software should make for less paperwork and simplify data collection, banking and client allocation. 

The bond between counsellors and trustees is a blessing. I am very grateful and thankful for everybody’s part. We are a good team and offer a very good service. 

Sue 

## **Financial Report** 

The income and expenditure have steadily grown over the past year as expected alongside client numbers. Income in April 23 was £420 with £446.20 expenses compared to Feb 24; income £653.12, expenses £248.80. The main income is client donations and expenditure is mainly counsellor invoices. The balance was £2,410.99 in April23 and £2,073.28 at the end of March24. The balance has decreased and our sub-committee for fundraising will be actively seeking grants to allow the agency to keep supporting low-cost clients. 

Looking ahead we hope to offer group courses and take on a placement counsellor in the coming year. 

|Looking ahead we hope to offer group courses and take on a placement counsellor in the<br>coming year.|Looking ahead we hope to offer group courses and take on a placement counsellor in the<br>coming year.|Looking ahead we hope to offer group courses and take on a placement counsellor in the<br>coming year.|Looking ahead we hope to offer group courses and take on a placement counsellor in the<br>coming year.|Looking ahead we hope to offer group courses and take on a placement counsellor in the<br>coming year.|
|---|---|---|---|---|
||||||
|**Summary Apr23-Mar24**|||||
|**Summary**|||**Bank balance**||
|**Income**|**£5,257.08**||**Balance b/f **|**£2,437.19**|
||||**Deficit**|**£363.91**|
|**Expenditure**|**£5,620.99**||||
|**Deficit**|**£363.91**||**Balance c/f **|**£2,073.28**|



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## **Data Review** 

Data covers the Period from 1[st] April 2023 to 31[st] March 2024. 

||Current<br>Year (Apr<br>23-24)|Apr 22-<br>23|Apr 21-<br>22|
|---|---|---|---|
|Number of individual clients seen|24|21|9|
|Number of new clients|19|18|9|
|Number of scheduled sessions|270|217|96|
|Number of delivered sessions|234|190|86|
|Number of cancellations|28|20|9|
|Number of DNAs(Did Not Attend)|8|6|1|
|Average Sessions Attended(for completed clients)|10.8|11.5|9.7|




**----- Start of picture text -----**<br>
40<br>35<br>30<br>25<br>20<br>15<br>10<br>5<br>0<br>Apr-22 May-22 Jun-22 Jul-22 Aug-22 Sep-22 Oct-22 Nov-22 Dec-22 Jan-23 Feb-23 Mar-23<br>Current Sessions (23-24) Last Year (22-23) (21-22)<br>**----- End of picture text -----**<br>


## Figure 1: Number of session per month 

## General findings 

- ➢ The number of sessions delivered to clients has increased this year by 44. The number of new clients seen has increased slightly, but does not reflect a few clients returning to the service. 

- ➢ With the increase in sessions and clients, there has been a corresponding increase in cancellations and DNAs, which represent 13.3% of scheduled sessions. This is an increase from 10.4% and 11.9% in the previous years. Most cancellations were in September and March, and most DNAs were in January. 

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- ➢ The average number of sessions completed by clients has fallen compared to last year. This reflects that many clients are feeling they do not require the full 12, with some only missing the final session. There were only two clients in the analysis who had an extensions. 57% of clients complete at least 12 sessions. 

- ➢ The trends in sessions per month shows that for 8 months at the start of the year (except July) there were more sessions than for the same month the previous year. However, from December there were similar or fewer sessions delivered compared to the previous year. The reason for this is unclear, however, some clients did take extended holidays in this time and there may have been effects from Christmas and the New Year. 

- ➢ One new couple was seen this year. There were several enquiries by couples but the limited counsellor availability did not match theirs. 

Considering the issues being brought by clients (Figure 2), it can be seen that the trends are again similar to the previous year. The range of issues is roughly the same, but some have gone e.g. Covid related issues and some are new e.g. domestic violence. These are the top 10 issues presented (those in brackets are from last year): 

1. Relationship issues (Relationship issues) 2. Anxiety (Anxiety) 3. Family (Depression) 4. Bereavement (Stress) 5. Depression (Low self-esteem) 6. Low self-esteem (Family) 7. Stress (Feeling more positive) 8. Eating disorders/Disordered eating  (Eating disorders/Disordered eating) 9. Suicide/Suicidal ideation (Social isolation) 10. Significant Life Changes (Suicide/Suicidal ideation) 

The issues are similar for the two years. However, “Family” has risen higher, with falls in “Depression”, “Low Self-esteem” and “Stress”. “Bereavement” is a new issue to the top 10 which is interesting to note. Suicidality has also risen up the list perhaps reflecting the trend seen last year in increasing complexity of clients seen. “Feeling more positive” is no longer in the top 10 which is disappointing, but might reflect that some clients are not completing 12 sessions and so not reaching a point at which improvements are addressed directly in sessions and so recorded by counsellors. 

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**----- Start of picture text -----**<br>
Figure 2: Client Issues<br>14.0<br>% Current Year % Last Year<br>12.0<br>10.0<br>8.0<br>6.0<br>4.0<br>2.0<br>0.0<br>**----- End of picture text -----**<br>


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## Outcome Measures 

At the beginning, middle and end of the set of sessions, clients complete 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 16 clients who completed a start and end set of forms. 5 clients were excluded from the analysis as they only completed forms at the start or start and middle. 

||RANGE AT<br>START|RANGE AT<br>END|MEAN START|MEAN END|MEAN<br>CHANGE|
|---|---|---|---|---|---|
|CORE (/40)|6-34|0-19|18.7<br>(Moderate)|8.6 (None)|- 10.8|
|PHQ9 (/27)|3-21|0-14|12.7<br>(Moderate)|4.5 (Just<br>Mild)|- 7.3|
|GAD7 (/21)|4-20|0-11.5|12.5<br>(Moderate)|4.3 (Just<br>Mild)|- 8.2|



||MEDIAN START|MEDIAN END|MEDIAN<br>CHANGE|
|---|---|---|---|
|CORE(/40)|21.5(Mod/Severe)|7.5(None)|- 14|
|PHQ9(/27)|12(Moderate)|4.5(Just mild)|- 4.5|
|GAD7(/21)|12(Moderate)|4(None)|- 7.5|



||CURRENT MEAN<br>CHANGE<br>(23-24)|PREVIOUS<br>MEAN CHANGE<br>(22/23)|CURRENT<br>MEDIAN CHANGE<br>(23-24)|PREVIOUS<br>MEDIAN<br>CHANGE(22-23)|
|---|---|---|---|---|
|CORE(/40)|-10.8|-8.4|- 14|-8|
|PHQ9(/27)|-7.3|-8.5|- 4.5|-10|
|GAD7(/21)|-8.2|-6.7|- 7.5|-5|



- It can be seen from the data that for all measures the counselling reduces the scores. For the CORE forms a change of 5 points is considered clinically significant. 

- The changes in the CORE and GAD7 values are higher this year than last year. Changes, although significant, are lower for the PHQ9 scores. The reason for this is unclear. 

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- Clients are coming in on average with Moderate difficulties and symptomology and mostly 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, as in the previous year. Upper scores are slightly higher this year compared to last year. The range for all scores is lowered to moderate levels. 

## **Counsellor Reviews** 

The summary includes the views of two of the three counsellors, as due to personal reasons the third has been delayed. 

All tasks have been completed by the counsellors, but they may need to check that their DBSs are up to date. Counsellors have seen an increased number of clients this year; between 7 and 9 clients. Usually between 3 and 4 clients are seen a week by each counsellor. Counsellors have recognised that it is hard work, but still find it enjoyable and rewarding. 

## Achievements 

All counsellors felt they had achieved a number of goals in this period, including adapting to short term work, greater confidence working with policies and procedures, diversifying their client base, setting up and using new tech (website and practice management software), and continuing to be in a supportive role for other members of the team. Counsellors felt that they had made improvements on their personal objectives, such as getting to grips with short term work, better record keeping, and data entry. The issues with the building, parking and its staff have also improved greatly. 

## Issues 

There have been some data analysis and tech issues, which are now improving. Management of DNAs and cancellation have been ever present, however, the creation of the sub-committee as a sounding board has been effective. There have been some difficulties finding who to refer clients to in the area, so this is an action point to be discussed with the board. Everything appears to be more stable than last year. Parking has improved, and although there have been a few issues with card reader these have been manageable. 

## Support 

There is a recognition that outside “life” factors can be a distraction. However, the support from supervision and peers not only ensured that clients were not impacted, but also helped with decision making in the long run on how to resolve issues. The team has been very supportive of one another, and this has come from fellow counsellors as well as board members, both in and out of monthly meetings. As mentioned, sub-committees have been effective sounding boards, alongside supervisors. Church staff are now in their roles more and this has allowed relationships to develop, meaning they can be approached more easily for support where appropriate. 

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## Goals 

Counsellors are happy to consider a number of development areas such as managing a student placement when the time comes, delivering and supporting the development of group work, seeing more couples, and offering workshops in the community. 

## Training 

No specific areas were mentioned in the review, but counsellors were happy to source their own, and are aware of their obligation to do so. 

## Improvements 

Counsellors would value the continued support of the trustees in tracking finances, which will get easier with the practice management software and the development of specific tools. Help with marketing and advertising workshops and group work to the community would also be appreciated. Trustees’ knowledge and expertise will also be useful in gathering referral pathways in the community as well as in other areas of the service. 

Counsellors identified the following ways that service could be enhanced: 

- Reaching out to businesses to offer services, for fundraising, and to raise awareness. 

- Taking a student counsellor on board. 

- Taking on another qualified counsellor, preferably able to do couples. 

- Take on more clients as a whole – which would require careful room management 

## **Trustee Reviews** 

All trustees took part in the review process. All actions were up to date, except for one trustee who had ongoing actions to be resolved by the AGM. 

Trustees feel that they can always turn to fellow trustees for help or opinions. The WhatsApp groups have worked well to facilitate this. Emails are responded to quickly and regular meetings allow members to be updated. The collaborative nature of the board means that members feel valued and supported and that we are a strong team together. It is hoped that the service will grow to perhaps include a trainee counsellor and an increased presence in the community. 

Trustees felt they have been able to conduct their roles well, especially in the following ways: 

- Attending meetings and contribute in constructive ways 

- Supporting counsellors 

- Being an active part of a sub-committee 

- Reviewing and updating policies 

- Improving trustee paperwork and agenda preparation 

- Supporting other trustees 

- Expressing views and ideas 

- Attending safeguarding training 

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- Allocating new clients to counsellors 

- Completing individual roles well 

- Responding quickly to emails 

- Setting up new software, and researching areas like NCPS membership and fundraising opportunities 

Some areas were identified as potentially being improved: 

- Some responsibilities could be addressed earlier or more thoroughly 

- The fundraising sub-committee need to engage in more investigations 

- Workshops might be offered 

- Getting links with local businesses 

- Linking more effectively with the AFC Safeguarding Co-ordinator 

Trustees felt that there should be more involvement in the process of taking on a trainee counsellor. There are also potential opportunities for trustees to market the service at different events and perhaps support the upcoming group work. This might require collaboration to utilise any local knowledge that trustees have in terms of referral pathways. It may be useful to assign small projects to individual trustees. With the new practice management software in place, trustees wish to help in keeping this operating smoothly to help with treasury tasks and client allocation. The need to perhaps gain some additional finding in the next 12 months was also acknowledged. Trustees are keen to continue supporting one another, as well as counsellors, with any personal issues which arise. 

In terms of further training for trustees, several areas were mentioned including, Linking Lives, safeguarding, marketing and fundraising. A few trustees have also completed training which might be beneficial. 

Banking and treasury issues related to IT have been present, but this will hopefully be rectified with the new practice management software. There was also an issue with completing the annual Charity Commission return, but this was solved through a collective effort. A review of how files and information is backed up, especially with regards to reviews will be done so this is handled more smoothly. Trustees also hope to keep connected whilst acknowledging life changes that might occur. 

## **Actions Taken Since the Reviews** 

Following previous reviews and this one, the following actions have been taken which address some of the issues raised: 

- The card machine which was purchased is now in use and is now the method by which most payment are made 

- A free contract with Cliniko (practice management software) has been set up. This means that counsellors have a shared diary in which to schedule appointments, record assessment and session notes and note down payments. This system will aid in the collection of service data, allow easier checking of payments and reduce the 

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amount of paper in the service. Counsellors were trained on the system in late March for use with new clients from the start of April 

- A subcommittee for fundraising has been set up. This has yet to meet to discuss options. However, options involving a large supermarket have been presented to the board for discussion 

- Discussions have taken place around taking on a possible new contracted counsellor and systems are now nearly in place to take on a student for placement if required 

- Everything is now in place to join the National Counselling and Psychotherapy Society. Trustees are currently deciding on which membership level to pursue 

- Group sessions have been written and hopefully these will start in the next few months 

## **Safeguarding** 

Safeguarding is a standing item at all our meetings, and it is at the centre of the work of the team of counsellors.  They are appropriately trained to maintain the safety of their clients, themselves and others using the building. 

The counsellors are all aware of the Safeguarding Policy and procedures at Adeyfield Free Church and how to report any observed Safeguarding concerns. 

The Safeguarding Officer of the church will consider running safeguarding training in the year ahead to raise awareness generally of this important issue.  This training will be offered to the counselling team. 

## **Client Feedback** 

We received 7 feedback forms this year, which is an increase from the 5 last year. All have provided consent for use of comments in reports. Online forms were made available but these were difficult to manage and no replies were received. 

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 bar one client rated the venue and location as Excellent. The other client rated it Good. The provision of parking was a positive attribute. The venue was described as calming, peaceful and safe, and the rooms as comfortable and welcoming. 

All clients agreed with the following statements: 

- I have a better understanding of my situation and I know what I can do about it 

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- I understand more about how my circumstances have affected me 

- I have been able to make decisions about my future (One client did not) 

Not all clients required access to other support services and so this was not applicable. 


**----- Start of picture text -----**<br>
Feel in control of emotions<br>Feel close to people who matter<br>People around that I trust<br>Positive coping skills<br>Taking good care of myself<br>Good about myself<br>Confident in myself<br>Make every day decisions<br>0 1 2 3 4 5 6 7 8<br>Strongly Agree Agree Disagree Number of Clients<br>Qualities at the end of therapy<br>**----- End of picture text -----**<br>


Figure 3: Changes to qualities after therapy 

Figure 3 shows that clients agree that positive qualities developed after counselling. The majority agree that things are better for them. Some clients still did not feel they were close to people or had people they could trust. This might be a reflection on the greater number of clients coming with specific relationship and family issues this year. Some clients also did not feel good about themselves or were not taking care of themselves. This might be another reflection of the complex nature of the clients and the severity of symptoms. The fact that there are improvements in other areas for these clients is a positive. 

Other reported benefits included: 

- Better sleep 

- Making better decisions 

- Putting boundaries in place 

- Better understanding of themselves and their situation 

- Realising not everything is their fault 

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## Selected positive comments 

“This service provides a lifeline to people in this community who have limited financial means - thank you.” 

“I've never had counselling before but I'm so grateful to have had this service. I felt listened to and understood. A welcoming, relaxed atmosphere.” 

“The service has impacted my life in a very positive way. I am much calmer and able to deal with difficult and stressful situations.” 

“I was assisted through a very difficult life transition and given the tools to be the best version of myself” 

“My counsellor was my safe haven where I could unload and process (my) burden each week” 

“It has helped me look at the situation from a different perspective and tackle any negativity about the way I've handled it in the past” 

“The service was excellent. I felt listened to.” 

“I left every session feeling like I had been listened to.” 

“I came for support for a childhood trauma but feel I have a much better understanding of how this has affected my adult relationships.” 

“A safe place where I could talk through worries and difficult situations” 

“…my counsellor helped me to understand how we relate to others. This has really helped me to see how our actions (mine as well as others) can trigger insecurities based on past experiences.” 

“The counsellor was easy to talk to. Her knowledge in understanding and zeroing in on the most important points helped me to view it another way. I couldn't have asked for better support.” 

“Being able to talk to someone about the deep pain and hurt that has kept my heart in bondage all my life” 

“I couldn’t have asked for better services.” 

“I felt I could be real and honest, and the support I received was non-judgemental.” 

“I now sleep better.” 

Suggested improvements 

“Better reception at the church. Sometimes it was difficult to be let in.” 

“Can be a little challenging to gain entry when no-one is on reception (only happened a few times though)” 

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This feedback from two separate clients was shared with the trustees. The employment of a building manager and a more consistent reception rota have improved access to the building. With the opening of the “Meet and Eat” area, access may be further improved on some days. 

## **Future Endeavours** 

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: 

- Consider approaching businesses to offer EAP or other support work to employees and increase revenue to offer more low cost sessions 

- Subcommittee to continue to explore possible funding or grant opportunities 

- Explore other signposting opportunities to clients for additional or specialised support 

- Advertise the service to more parts of the community 

- A new contracted counsellor or student on placement may be taken on in the coming months 

- Depending on the success of any groups which are run, more can be offered throughout the year. There is also the possibility of running educational workshops on a range of topics which could be explored further. 

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