School Counselling: Primary Vs Secondary
Insight

School Counselling: Primary Vs Secondary

Martin Huggins
by Martin Huggins
Published on May 12, 2025
0 min read

Should we be working differently with key stage 4?

Why?

Approximately half of adults with mental health disorders experienced their initial symptoms before the age of 14. The post-pandemic affect appears to be accelerating the mental health challenges we now face in society, with convincing evidence that the mental health of young people is in rapid decline and national mental health services are stretched.

What’s happening?

A 2019 survey conducted by the British Association for Counselling and Psychotherapy (BACP), with nearly 6,000 people responding, found that over three quarters of parents wanted to see counselling services available in all schools. The good news is that over 85% of UK secondary schools now offer access to counselling services. This figure isn’t quite so high for primary school settings, although in Plymouth we seem to be bucking the national trend with over 95% of our local primary schools having access to therapists through MAST.

What are the differences?

A series of reviews of school counselling, conducted for the BACP, suggested that those students seeking counselling in UK secondary schools highlighted family tensions as the most common reason, with anger, school issues, and relationships, or friendships, as the next most prevalent.

Within those primary schools surveyed, of the 21 different issues recorded, the most common were:

  • Generalised anxiety (73%)
  • Attention difficulties (71%)
  • Low self-esteem (71%)

The least common issues being:

  • Eating difficulties (15%)
  • Self-destructive thoughts (13%)
  • Suicidal ideation (5%)

However, these last 3 were much more significant issues for those engaging with secondary school counselling services.

Does one size fit all?

Having worked as a School Counsellor for just over 10 years now, in both primary and secondary settings, I understand the need to tailor support and interventions appropriately: for example, play therapy versus talking therapy. Although the research indicates differing presenting issues between primary and secondary children, we must be prepared to work on a very individual basis and not to pre-judge based on age or stage of life.  

A final thought

Of course, there will be similarities within particular year groups, as the research shows, but it is important not to assume that a child in primary school could not have an eating disorder, or that developing the therapeutic relationship with someone older may need to involve play, art, music, drama or a much more creative approach than the traditional face-to-face talking therapy confined to the therapy room.  As Carl Rogers, the founder of person-centred therapy, once said “In my early years as a therapist I was asking the question; How can I cure, treat or change this person? Now I would phrase this another way; How can I provide a relationship that this person may use for their own personal growth?”

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