Change processes in school-based counselling: A Hong Kong study

Mark Gregory HARRISON

Research output: ThesisDoctoral Theses


A large body of research suggests that counselling is an effective intervention for adolescents experiencing psychological distress. Little is understood about the processes taking place in such counselling, however. School-based counselling in Hong Kong is not well developed or researched, despite having the potential to be a valuable intervention. The present study sought to investigate the processes taking place in school-based counselling in Hong Kong and the ways in which the Chinese sociocultural context and the school setting influences these processes.
Semi-structured interviews were conducted with 25 Hong Kong Chinese senior students and 8 counsellors across three different schools. Data were analysed thematically within a critical realist framework, allowing shared meanings to be reported with an emphasis on causal mechanisms and the influence of context. Two thematic domains were developed from the data which captured the experience of both students and counsellors.
The first thematic domain was labelled relationship in context and consisted of four themes: counselling embedded within the school and the culture; the pre-counselling stage; building a counselling relationship; and an ongoing but limited source of support. After experiencing initial fear and uncertainty, students quickly established a strong and stable relationship with their counsellor. Counsellors’ embeddedness into the school enabled them to act as an ongoing source of support, which students valued but which could also foster dependency. Seeing counsellors as authority figures, being unwilling to disclose personal information outside the family and stigma related to mental health issues were traditional cultural perspectives which heightened students’ fears related to attending counselling. Trust was an essential precursor of developing a counselling relationship in which the counsellor was perceived as warm, non-judgmental, caring and empathic.
The second thematic domain was labelled change processes, and three such processes were identified. In the first, labelled new ways of thinking, students developed insight into their thinking and became more realistic about and accepting of their problems. This led to increased optimism and resourcefulness. In the second change process, developing better relationships, students learned to connect with other people better through practising communication, developing social skills and learning to empathise. This connection enabled students to value their relationships more, to become more accepting of other people and to experience greater self-advocacy in relationships. Finally, in experiencing positive emotions and increasing elfefficacy, students experienced positive emotions as a result of being able to talk and feeling that they were understood and accepted, and this led to a better mood, greater confidence and a feeling of ease which, in turn, allowed them to be more focused at school. The change processes were not mutually exclusive, and there were differences in the way students experienced them.
The study’s findings allowed several recommendations for counsellors and administrators to be made. In particular, a sensitivity to the sociocultural context and the embeddedness of counsellors in the school organisation is essential to the effective implementation of schoolbased counselling in Hong Kong. All rights reserved.
Original languageEnglish
QualificationDoctor of Education
Awarding Institution
  • The Education University of Hong Kong
  • HOU, Wai Kai 侯維佳, Supervisor
  • HUE, Ming Tak, Supervisor
Publication statusPublished - 2019


  • School-based counselling
  • Change processes
  • Thematic analysis
  • Critical realism
  • Theses and Dissertations
  • Thesis (Ed.D.)--The Education University of Hong Kong, 2019.


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