A Large School Counseling Program Tested Without a Control

What the program contained

Two hundred and seventy school counselors in thirty-one Turkish cities taught the same sixteen lessons to 7,129 adolescents, and no class was held back for comparison. The sessions ran one each week, forty-five minutes long, in the ordinary classroom. Every adolescent held a workbook, and every session ended with a home activity that rehearsed the skill just taught.

The program is called Super Skills for Exams. In May 2022 the private Turkish school chain Ugur College asked Cecilia Essau of the University of Roehampton and Bilge Uzun of Bahcesehir University to adapt Essau’s anxiety and depression prevention program, Super Skills for Life, for students facing the national placement examination taken at thirteen. Its original eight sessions were expanded to sixteen so the course could run across a full academic year.

Its content comes from cognitive behavioral therapy. Students learn to identify and argue with worry cognitions, which here means beliefs such as being incapable of the work, and to recognize avoidance in themselves. A second component, behavioral activation, raises activity levels and adds positive activities on the premise that doing more lifts mood and self-esteem. Social skills training and social problem solving supply a third. Students are also briefed on what to look for and then shown a recording of their own performance, a technique for correcting self-appraisal. Further sessions cover diet, physical activity and sleep hygiene.

The counselors attended an intensive two-day workshop in Istanbul run by Essau and Uzun, received a leader’s manual setting out each session, and were supervised by Uzun roughly every two weeks through the year.

The evaluation was an open trial. Every student received the program, so nothing in the design separates the effect of the sessions from the effect of a year passing. All outcomes were questionnaires the adolescents completed about themselves, one week before the program and one week after. The sample was 7,129 students in grades 7 and 8, mean age 12.6, drawn from all 245 Ugur secondary schools across 31 cities, and the paper reports no effect sizes for any result.

On the test anxiety subscale of the Motivated Strategies for Learning Questionnaire, the average fell from 15.09 to 14.23, and self-efficacy for learning rose from 33.23 to 35.22. Study pressure fell from 13.36 to 12.31, self-expectation from 18.48 to 17.65, despondency from 11.62 to 11.30. Worry about grades did not shift, in boys or in girls, and neither did physical activity or health responsibility. Reported healthy eating rose. Over one academic year, 270 counselors delivered the same sixteen sessions to more than seven thousand adolescents, and the questionnaires came back different at the end of it.

What it means for you and your child

Schools increasingly offer wellbeing or exam-stress provision, and parents are rarely told what is inside one. A school can be asked how many sessions, how long each runs, who delivers them, what training that person received, whether a written manual governs the content, whether anyone supervises delivery through the year, and whether children practice between sessions. Programs that share a description can differ enormously on those points.

What this study establishes is narrower than its size suggests. Uzun and colleagues state plainly that the design cannot rule out the passage of time as the explanation, and they call for a randomised controlled trial to test whether the findings hold. They also recorded no check on whether the counselors followed the protocol, so the fidelity of 270 separate deliveries is unknown. The analysis compared the before and after scores as two independent groups rather than following the same students across the year, which is an unusual choice for a pre-post design. Where 7,129 adolescents took part, the movement in the averages was a point or two on scales running to 30 and above.

Worry about grades, the item closest to what a family actually hears at home, did not change for either sex, and it was the one measure of academic stress that held still while the others gave way. Girls reported higher test anxiety, higher self-expectation and more despondency than boys before the program began, and eighth graders reported more academic stress than seventh graders, which fits a cohort with the examination directly ahead of them.

Skills of this kind are rehearsed rather than installed, and the researchers who built this one judged that a school year of weekly practice was the necessary quantity. Sixteen sessions is a substantial commitment of a child’s timetable and of a counselor’s, and against that, an open trial with no comparison class returns a modest shift in how a group of adolescents rated themselves.

A program of this size is a year of a child’s timetable, and a year is also how long it takes before anyone can say what it bought.