Evaluating the evidence base for university counseling services and their effectiveness using core measures: a systematic review and meta-analysis

BACKGROUND: The Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) is a pantheoretical measure of psychological functioning. Use of routine outcome measures (ROMs) assessing university counseling outcomes (i.e., clinical effectiveness) are essential to demonstrate evidence-based practice. But the evidence in higher education is limited as data usage and adoption of ROMs are not inherent within services, restricting knowledge of their effectiveness. This systematic review and meta-analysis document the evidence-base for in-house university counseling services (UCSs) and use of ROMs. METHODS: The review protocol was pre-registered on PROSPERO doi:tinyurl.com/2vw5464d and reported following PRISMA guidelines. Scopus, PsycInfo, Opengrey, reference lists, and Sheffield Star Plus were searched March 22nd, 2021 and May 29th, 2024. Subgroup analyses explored the effectiveness of services using multiple therapies compared to a single therapy. RESULTS: 15 studies (N = 28,237) were included in the narrative synthesis and 13 studies (N = 14,795) included in a meta-analysis. CORE-OM data showed a large pre-post effect size (g = 1.19) demonstrating a reduction in students' psychological distress. The effect size for services using a range of therapies was significantly larger (g = 1.34) than those using a single therapy (g = 0.90). LIMITATIONS: The small number of papers demonstrates the limited body of evidence evaluating the effectiveness of UCSs. Lack of follow-up rates, likely due to limited ROM adoption, also hindered the evaluation. CONCLUSIONS: Quality of studies was good and UCSs are more effective than comparative CORE-OM benchmark data of no treatment derived from a large dataset of psychological therapy services.