Coming Home to Ourselves:

Evaluating the outcomes of counselling provided by icap

The full report is available to download here.

This was an independent evaluation of new clients entering icap’s service, assessing them through a range of standardised measures at the start of treatment, and then 6 and 12 months later. 6 months after the start of psychotherapy at icap, clients reported significant improvements in their general psychological wellbeing, evidenced through:

  • Reductions in symptoms of post-traumatic stress disorder
  • Reductions in self harming behaviours
  • Reduction in drug and alcohol misuse
  • Reductions in depression and anxiety
  • Improved social functioning

These improvements were maintained throughout the entire period of observation.

Specific groups of clients showed particular improvements:

  • Victims of domestic violence made the most improvement in their general psychological functioning
  • Self-harming and suicidal clients with drug/alcohol problems reported significantly less substance misuse post-treatment
  • Second generation Irish clients, male clients, married clients, and those who had work or sexuality difficulties as a presenting problem reported the greatest reduction in their depressive symptoms over the course of therapy
  • Second generation Irish clients made the most improvement in their interpersonal problems over the course of treatment

Some groups of clients appeared to be particularly difficult to treat in some domains of functioning.

  • Male clients and clients with anger problems were less likely to significantly reduce their alcohol misuse
  • Clients who initially presented as being overly controlling and vindictive or cold and distant struggled most in improving their social and relational skills

Some groups of clients tended to be offered and take up more long-term psychotherapy. These clients responded well to the longer-term treatment and made the most improvement between 6 and 12 months after the start of therapy.

  • Clients who reported high level of self-harm stayed in therapy for longer and improved more in their self-harm behaviour than others.
  • Clients with severe drug problems stayed in therapy for longer and made more improvement in their drug use than other clients

This report provides empirical evidence that the psychotherapy provided by icap may be effective in helping people to overcome social and emotional difficulties, and demonstrates particular effectiveness in addressing complex and “hard to reach” symptoms. A comparison of icap’s outcomes with those reported in the largest review of psychotherapy outcomes in the UK to date (Stiles et al. 2008), shows icap outcomes on a par with NHS-based psychotherapy services. However icap patients had much more complex problems at the onset of therapy, evidenced in significantly higher CORE scores, than any of the other groups studied, suggesting that icap’s therapy may have added more value with a hard-to-treat population with more complex needs than the general population.

The authors recommend further and wider research to build upon these findings, and to examine the qualitative ways in which icap’s culturally specific treatment is achieving its positive outcomes.