Relationship in context: Processes in school‐based counselling in Hong Kong

Aims: Little is known about the processes taking place in school‐based counselling, particularly in Hong Kong, where the sociocultural environment may influence these processes. This study investigated students' engagement with counselling from the perspective of students and school counsellors in Hong Kong.
Method: Semi‐structured interviews were carried out with 25 ethnically Chinese students and eight counsellors over three schools in Hong Kong. Data were analysed thematically within a critical realist paradigm.
Results: Four themes were developed which captured students' experiences of school‐based counselling: "Counselling embedded into the life of the school"; "Fears about counselling"; "Building a counselling relationship"; and "An ongoing but limited source of support." A top‐level theme called “Relationship in context” encompassed the four themes.
Conclusions and implications: Counsellors' embeddedness into the school's organisational structure enabled them to act as an ongoing source of support, which students valued but which could also foster dependency. Counsellors taking on additional roles in the school led to confusion on the part of both students and counsellors and limited the effectiveness of counselling. Seeing counsellors as authority figures, being unwilling to disclose personal information outside the family and stigma around mental health issues were 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‐judgemental, caring and empathic. A sensitivity to the sociocultural context and the embeddedness of counsellors in the school organisation are essential to the effective implementation of school‐based counselling. Copyright © 2019 British Association for Counselling and Psychotherapy.